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tv   Health Care  CSPAN  November 3, 2013 10:30am-2:06pm EST

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-- the chairman and the chairwoman are looking for congressional leaders in the white house to set up a topline to an agreement/ . i also believe they are little the finalabout product they produce making it through the house. the things that we saw happen over the summer in terms of getting a bill through underscored the question about the volatility of the house and what would happen. of unclear as to exactly how much the white house will step in, but on the other hand hollered peterson -- collin the white house gets too deeply involved, whatever help -- they were for, the house would be against. >> he is working behind the
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scenes, and helping them out policy-wise.- what does the house want to do ultimately, because they separated the farm bill from the food stamp bill, and tackle them separately. the houseot know what is going to do, because we have a very factionalized house of representatives. they say keep the food stamps and the farm bill separate raid -- separate. a lot of the institutions on capitol hill see themselves as them again the world. against the world. trying tosswoman is be a good soldier, and the
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democrats are trying to get a bill through, but they know that the snap program is very important. if they had for different -- figured out how to bridge these gaps, we would have progress. >> the house and senate conferees are trying to negotiate some sort of deal on what they call on the ground -- common ground. does the farm bill get thrown in that? could be part of the budget agreement, and that is a good and bad thing for the senate committee. it is good because it is part of the bill, but then they lose control of it at that point. >> thank you for your time. >> i am a firm in what they call -- believer in what they call
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the unauthorized biography. it does not mean that it is untrue, it means that you are doing it without the blessing or cooperation of your subject. it is a legitimate way to cover apart frompecially ofse who have spent millions dollars creating their own image. the one who was trying to get behind that and tell you what is going on. americancal history, tv's in- today on book depth on c-span2. john foster dulles had
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recently died when that super airport was being built, and immediatelysenhower announced it would be called irport.l part -- ar you can still see the film clip of kennedy opening the airport with eisenhower there, and he pulls back a curtain, and behind tain is a giantur bust of dulles. i went to see it, and i could not find it. the security guards, and it was a long process, and and i was able to discover that the bust had been taken away from its place in the middle of the airport, and it is now in a closed comforts the room opposite baggage claim number
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three. i find this a wonderful metaphor for how the dullest mothers -- brothers, who wielded such power have been relatively forgotten. led overlles brothers during theoperations cold war. see why that still can be felt 60 years later tonight on c- span's q and a. 's health andweek human services secretary kathleen sibelius had her first appearance before the committee. on some of the problems, and how they are being fixed. she also addressed the issue of
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individuals being served cancellation notices from their insurance providers. this hearing is about three hours. -- three and a half hours.
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>> good morning. the energy and commerce committee welcomes the president's point person on health care. secretary sebelius. we look forward to the
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conversation on a number of issues, including transparency and fairness. over the months leading up to october 1 launch, the secretary and her colleagues repeatedly looked us in the eye and testified that everything was on track. despite the numerous red flags and lack of testing, they assured us that all systems were a go. something happened along the way. either those officials did not know how bad the situation was or they did not disclose it. sadly, here we are now five weeks into enrollment and the news seems to get worse. it crashed multiple times. even this morning, when we attempted to view the site, we were hit with an error message. this is more than just a website problem. that was supposed to be the easy part, remember?
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americans were assured that their experience would be similar to other online transactions and that their sensitive personal information would always be secure. after more than three years to prepare, malfunctions have become the norm and the administration has pivoted from saying they are on track to setting a new target date of november 30. for those few americans who have successfully applied, will the website glitches become provider glitches? this situation should rise above politics. many folks watching at home have spent hours or days to sign up. they continue to take time away from work or loved ones but have made little progress. soon they may worry about being on the wrong side of their government facing potential penalties. i recently spoke to a woman from michigan who was excited to sign up but has since become very disillusioned after spending hours on the phone and website with little success. there are millions of americans who believe that the president
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when he said, if you like your plan, you will be able to keep it no matter what. they are now receiving termination notices. they may be losing their faith in their government. today's hearing is about fairness for the american people were losing their coverage or seeing their premiums skyrocket as much as 400%. it is also about transparency. while the administration continues to boast about the numbers of americans who have applied, they withhold precise enrollment numbers. why? these numbers are critical to understand the status of implementation. lead contractor cgi testified that they had the data but needed the administration's permission to release it. we asked the secretary for those figures on october 8, but have still not received a response. we hope to get one today. the american people deserve answers as well as the peace of mind that promises should be
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kept. the secretary has an opportunity to restore the public's faith in the administration. >> thank you, mr. chairman. secretary kathleen sebelius is here to discuss the affordable care act. just like medicare part d, the launch of the website has not gone well. but the early glitches in this rollout will soon be forgotten, just like medicare part d. a lot of the discussion will focus on the website. this is an important issue. i want to learn what the secretary can tell us about the problems and how they will be fixed. we should keep this issue in perspective. the affordable care act is working. it has been improving the health security of millions of
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americans for the past three years. because of the affordable care act more than 7 million people on medicare have saved more than $8 billion on their prescription drugs. more than 100 million americans have access to free preventive coverage. they no longer face lifetime limits on their coverage. over 10 million americans have received rebates from insurance companies. finally, this january, the worst abuses of the insurance industry will be halted. never again will a family be denied coverage because their child has a chronic health condition. never again will individuals see their premiums shoot up because they got sick or face an unexpected medical expense.
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never again will a woman have to pay twice as much as a man for the same insurance. that is why allowing insurers to continue offering deficient plans next year is such a bad policy. the law says that all plans, except those that were grandfathered in 2010, must be the new consumer protection standards. if we don't enforce this policy, insurance companies can continue offering flimsy coverage that disappears when people actually need it. no one should want that. it is understandable that there will be a focus today on what is not working. we must also remember what is working. the health insurance plans that are being offered in the exchanges are good plans. their premiums are much lower
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than expected. 60% of the uninsured individuals shopping in the new marketplaces to be able to get coverage for less than $100 per month. half of the young adults will be able to get coverage for less than $50 per month. since congress adopted the affordable care act, health care costs across the whole economy have fallen to their lowest level in decades. the success of the affordable care act is due to the efforts of many people. one individual more than any other is responsible for all of the good that has been accomplished and that is our witness today, secretary kathleen sebelius. my colleagues need to stop hyperventilating. the problems are unfortunate. we should investigate them. they will be fixed. and then every american will finally have access to affordable health insurance. >> thank you, mr. chairman. >> before we swear in secretary sebelius, i want to clarify the swearing-in process.
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as is the case with all policy witnesses, she was not required to take an oath prior to testifying previously. today's hearing is different. it is an oversight hearing. it is policy to swear and all witnesses at oversight hearings. >> thank you for your comments. i want to join you in explaining that swearing-in of the witness before an oversight committee hearing has always been under oath. that is the standard procedure in this committee when we are
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conducting an oversight committee. it may seem strange to have the secretary of health and human services sworn in, but all witnesses are sworn in at oversight committee hearings. >> the honorable kathleen sebelius was appointed to her position in april 2009. she was sworn in as the 21st secretary on april 28, 2009. i will not swear you win. if you would rise -- i will now swear you win. if you would rise. do you have any objections to testify under oath? do you swear that the whole testimony you give will be the
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truth, the whole truth, and nothing but the truth? you are now under oath and subject to the penalties set forth in the u.s. code. you may now give a five-minute summary of a written statement. welcome again. thank you for being here. you have to use that mic. you don't know how many people want to hear you this morning. [laughter] >> thank you. i left my position as governor of kansas 4 1/2 years ago to expand the opportunities for all americans, regardless of geography or gender or income, to have affordable health coverage. during my years as a state legislator, as an elected insurance commissioner, as a
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two-term governor, and now as hhs secretary, i have worked on that effort that i care deeply about. there are still millions of americans who are uninsured as well as underinsured. people who have some coverage at some price for some illness, but have no real protection from financial ruin and no real confidence that they will be able to take care of themselves and their families if they have an accident or an illness. for them, a new day has finally come. in these early weeks, access to has been a miserably frustrating experience for way too many americans. including many who have waited years, in some cases their entire lives, for the security of health insurance. i am as frustrated and angry as anyone with the flawed launch of so let me say directly to these americans, you deserve better. i apologize. i am accountable to you for
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fixing these problems. i am committed to earning your confidence back by fixing the site. we are working day and night and we will continue until it is fixed. we have recently added new management talent, additional expertise, and a new general contractor to fix the system in two broad categories. performance and function. our extensive assessment has determined that the website is fixable. i want to outline some of the improvements. we have more users successfully creating accounts. we can process 17,000 account registrations per hour. 5 per second. users can now see whether they are eligible for financial assistance and make more
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informed decisions. consumers can shop for plans quickly. filtering plans takes seconds, not minutes. users are getting fewer errors and timeout messages as they move through the process. the system has been strengthened through double the size of servers, software, that is better optimized through a physical database that replaces a virtual system. the chairman referred to outages this weekend and yesterday. if you read the statement from verizon, it is the verizon server that failed and it affected not only hhs, but other customers. we have a plan in place to address key outstanding issues.
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fixing bugs so folks can navigate without error messages and slow response times. by the end of november, we are committed that users will be able to navigate without the problems that too many have been experiencing. consumers are using the site and continue to do so. problems are being solved. but we know that we do not have a fully functioning system that consumers need and deserve. we are still at the beginning of a six-month open enrollment that extends through the end of march. there is plenty of time to sign up. to put it in perspective, the average open enrollment for an insurance plan is 2 to 4 weeks. this is a 26-week open enrollment. those who enroll by december 16 will be able to access the benefits on day one. even with the unacceptable problems which we are committed to fixing, the affordable care act, by any fair measure, is working for millions of americans.
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they are benefiting from new health security, young adults, americans living with pre- existing health conditions, seniors on medicare. 85% of americans who already have health coverage are protected with new rights and benefits. 15% of our neighbors and friends who are uninsured have affordable new options in a competitive market. cost growth for health care is lower than it has been in years. millions of americans are clearly eager to learn about their options and to finally achieve health security and possible by the affordable care act. my commitment is to deliver on that promise. thank you, mr. chairman. >> thank you very much. if you could move the mic closer. let me start this clock. i appreciate you being here this morning. we have worked with our leadership to see that we do not
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have votes on the house floor this morning, so we will not be interrupted. i appreciate your time, for sure. in an effort to allow every member to ask a question, we will be reducing the time for questions to be just 4 minutes. hopefully we can get through all of the members that are here. i will be pretty fast with the gavel. we have plenty of questions. let's try to get through them. i think everyone in america remembers the president's words. if you like your health care plan, you can keep it. under the affordable care act, insurance policies that were in effect on march 23, 2010, when the law was enacted, would be grandfathered. then a few months later, despite the president's word, hhs helped promulgate a new reg that would deny as many as 50% of those
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holding individual policies the right to renew their own insurance plan. i would guess that there are a lot of us on this panel today who are hearing from angry and confused constituents, who are being forced to go onto a website whether they like it or not to shop for a new replacement policy. they are finding premiums, often more than 100% what they are paying before. some even as high as 400% that i have heard from. rising deductibles as well. so, when was the president specifically informed of the regulation change and if so was appointed out that this totally undermined his biggest selling point? i would note that on the screen,
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in a statement that he made more than three years after the regulation change was promulgated, the president said again, the first thing you need to know is this, if you already have health care, you don't have to do anything. he has been on the same page from the very start. yet the regulations changed months after the bill was enacted that are now causing perhaps millions of americans be denied the ability to renew their individual coverage. why was that change made? and did the president know it? >> mr. chairman, there was no change. the regulation involving grandfathered plans, which apply to both the employer market and the individual market, indicated that if a plan that was in effect in march of 2010 without
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unduly burdening the consumer, that plan would stay in effect and never have to comply with any of the regulations of the affordable care act. that is what the grandfather clause said. the individual market, which affects about one million americans, about 5% of the market, they often have coverage for less than one year. one third of them have coverage for about six months. if a plan was in place in march of 2010 and did not impose additional burdens of the consumer, it is grandfathered in. >> why not let the consumer decide whether they want to renew it or not? why undermine the ability for them to re-sign up? >> there were no regulations changed. we outlined the grandfather policy so people could keep their plans. we then begin to implement the other features of the affordable care act. if someone is buying a brand-new policy in the individual markets today, they will have consumer protection for the first time. many people in the individual markets are medically underwritten. that will be illegal.
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many women are charged 50% more than men. that will be illegal. you cannot eliminate someone because of a pre-existing health condition. you can't dump someone out or lock someone out. if a plan is in place and was in place at the time that the president signed the bill and the consumer wants to keep the plan, those individuals are grandfathered in and that is happening across the country in the individual market. >> we are learning that folks who did have a plan and liked it are told that it is being canceled. let me yield to the ranking member. >> thank you. i have to smile at your line of questioning. everybody expected this hearing was about the website. that is all we have been hearing about is the website. that is not the only complaint
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we have been hearing about the affordable care act was adopted. we were told, by our republican friends, that millions of jobs would be lost. in fact, there has been a gain of 7 million jobs. they said that cost of health care would sky rocket. the opposite is true. there would be a massive shift of part-time jobs. the evidence does not support that. in fact, everybody in this country will have access to health insurance because they will not be discriminated against. they said it would explode the deficit. all the reputable organizations, like the congressional budget office, have told us that it will save us $100 billion over 10 years. we have had a litany of objections from the republicans about the affordable care act, which have driven them to such a frenzy that they even close to the government.
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now we have you before the committee and you are being asked about the website. let me pursue this question about individuals who have gotten notices that they will have their individual insurance policies canceled. they will be able to get another plan what they? >> continuous coverage as part of the law. it is the law. that was not the case in the past. >> we will end the worst abuses of the insurance industry. we will create consumer protections in the marketplace that they will be able to buy a policy even if they have been sick in the past. women will not be charged more than men. insurance companies will not be able to deny coverage based on
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pre-existing conditions. they will not be able to place lifetime caps. they will be in the central benefits package. you are not buying some things, you will have the minimum that everybody should have. prescription drugs, mental health coverage, doctors, and hospitals. >> as a former insurance commissioner, i can tell you that the individual markets in kansas and in the country have never had consumer protections. people are on the run. they can be locked out, priced out, and dumped out. this will finally provide the individuals in the buying insurance on their own, families, entrepreneurs, mom and pop shops never had that kind of health security. >> now they will have this health security. most of the plans, as i understand it, they are no longer going to be able to keep don't meet all the standards of the law. >> again, i think you may have heard pat garrity from florida, he talks about the fact that the florida plans want to keep their
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customers. they have new plans to offer. they feel that a lot of people and these are mr. garrity's words -- will have a much better plan at a similar or lower cost, 50% of these 11 million to 12 million people qualify for a subsidy. qualify for financial help purchasing insurance for the first time ever. >> the bottom line is that people with good coverage like medicare, medicaid, employer coverage can keep that. people with grandfathered plans on the individual market will be able to keep it. but if an insurance company sold you a new, modified health insurance policy after the date of the enactment that does not meet the law's standards, those people will be able to buy a real, solid health insurance plan that won't discriminate against them or anybody else. i think that's a good result.
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i'm pleased with it. i think most people will be as well. >> the gentleman's time has expired. the chair would recognize the vice chair of the committee, mrs. blackburn. >> thank you, mr. chairman. madam secretary, before, during and after the law was passed, the president kept saying, if you like your health care plan you can keep it. so is he keeping his promise? >> yes, he is. >> what do you say to the 300,000 people in florida, you just mentioned, or to the 28,000 in tennessee who cannot get health insurance, their plans are terminated, is he keeping his promise to them? >> first of all, congresswoman, they can get health insurance. they must be offered new plans, new options either inside the marketplace or if they don't qualify for a subsidy -- financial subsidy they can shop or out of the marketplace, they absolutely will have new coverage. >> what do you say to nbc news millions will lose their coverage?
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>> in all deference to the press corps, many of whom are here today, i think that it is important to be accurate about what is going on and i would defer, again, to the president of the -- they will be offered new plans. >> madam secretary, let me tell you something -- >> will call to -- >> what do you say to mark and lucinda in my district who had a plan, they liked it, it was affordable, but it is being terminated and now they do not have health insurance? >> insurance companies cancel individual policies year in and year out. they are one-year contracts with individuals. they are not lifetime plans. they are not an employer plan. >> let me move on. it is what they wanted. i will remind you, some people like to drive a ford and not a ferrari. some people like to drink out of a red solo cup. not a crystal stem. you are taking away their choice. let's put a screenshot up. i want to go to the cost of the website and talk about the website. this is what is happening right now with this website. we've had somebody in the back trying to sign on. it is down.
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it is not working. last week i asked for the cost from each of the contractors that were with us last week. so can you give me a ballpark of what you have spent on this website that does not work, that individuals cannot get to? what is your cost estimate? >> so far, congresswoman, we have spent about $118 million on the website itself. and about $56 million has been expended on other i.t. to support the web. >> ok. would you submit a detailed accounting of exactly what has been spent? and when do you expect constituents to stop getting these kind of error messages? >> again, i talked to the president of verizon over the weekend on two occasions. verizon hosts the cloud which is not part of the website.
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it is a host for a number of websites. the verizon system was taken down saturday night into sunday. it was down almost all day sunday. they had an additional problem that they notified us about yesterday. and it continues on. i would be happy to talk to the president of verizon. and get him to give you information about that. >> let me come back to that. i want to get to this issue of exactly who was in charge of this. project. because you're now blaming it on the contractors and saying it's verizon's fault. so let me ask you this -- did you ever look at outsourcing the role of the system integrator and, obviously, you did not, from the contractors that we had last week, you all -- they had several different people -- whether it was you or gary cohen or michelle snyder or henry chow that they were in charge, so who
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is responsible for overseeing this project? is it you or your designee? >> let me be clear, i am not pointing fingers at verizon. i am trying to explain the way the site operates. we own the site. the site has had serious problems. >> who is in charge, madam secretary? >> the person now in charge as an integrator is qssi, one of our -- >> who was in charge as it was being built? >> in charge -- >> at that team, who is the individual? >> michelle snyder. >> michelle snyder is the one responsible for this debacle. >> well, excuse me, congresswoman, michelle snyder is not responsible for the debacle. hold me accountable for the debacle. >> i yield back. >> the chair recognizes mr. dingell from the great state of michigan. >> mr. chairman, thank you for your courtesy. i will ask you a couple of questions on behalf of congresswoman shea-porter. i ask permission that i revise and extend my remarks.
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>> without objection. >> mr. chairman, i'd like to begin by thanking you, welcoming the secretary into a room in which her distinguished father, former governor of ohio served so many years. i begin my questions by quoting from an expert for whom i have enormous respect. he said, as follows -- as i mentioned earlier, the new benefits and its implementation are hard to perfect. rather than trying to scare seniors, i hope we can work together to go through the implementation phase to find out what is wrong with the program and if we could make some changes to fix it. let us do it and let us do it in a bipartisan fashion. it is too big a program and is too important to too many people to do that. but having said that, it does not appear that it is working. let us admit it, you know, and not keep beating a dead horse, my beloved friend, mr. barton, who i think gave us the beginning of our efforts today.
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madam secretary, i have seen reports that consumers receiving plan cancellation notices from their insurance companies saying that plans are no longer available. does the a.c.a. require insurance companies to discontinue the plans that people had when the law was passed, yes or no? >> not when the law has passed, if the insurance changed, that's the grandfather clause. >> if an insurance company is no longer offering a certain plan, it's because that insurance company made a decision to change their policies. and that caused them to take away the grandfathered status from their insurance purchasers, is that correct? >> that's correct. >> now, madam secretary, i want you to submit for the record a statement of what it is we can do about insurance companies that run around canceling the
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policies of their people. i don't have time to get the answer, but i want to get a clear statement from you as to what you can do. so take some skin off of folks that have it coming. now, madam secretary, it's my understanding that these decisions of a business character are most common in the individual insurance market and that much turnover already exists and existed prior to the enactment of the legislation. >> that is correct. >> is that correct? >> yes, sir. >> is it correct that 35% to 67% of the enrollees in the individual markets leave their plan after one year for different reasons? >> a third are in about less than six months in the individual market. and over 50% are in for less than a year, yes, sir. >> now, in the cancellation letters, which move around from the insurance companies, some insurance companies are suggesting an alternative plan
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at a higher price. do they have a right to do that? >> they have a right to do that, sir. consumers have a right to shop anywhere to medicare plans and they have choices now that they've never had before and some financial assistance. >> and they have no right to enforce that demand on consumers? >> absolutely not. no one is rolled over into a plan. in fact, individuals for the first time ever will have the ability to compare plans, to shop and to make a choice inside or outside the marketplace. >> looks to me like the insurance companies are trying to inflict on their customers the view that this is their right and that this is the only option available to them, is that correct? >> well, i think that insurance companies would like to keep their customers. having said that, customers have a lot of choices.
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>> -- >> there is no role. quite the gentleman's time is expired. >> they come forward and tell you that you have to buy a particular policy. is that right? >> absolutely. >> the gentleman's time is expired. the chair recognizes the gentleman from texas, mr. barton. >> thank you, mr. chairman. we have a former member of the committee on a general -- on a democrat side from the audience, mr. slattery, and we're glad to have you. madam secretary, we're glad to have you, too. there is a famous movie called the "wizard of oz, and in the wizard of oz, there is a great dorothy turned to her little dog toto and says we are not in kansas anymore. madam secretary, while you are from kansas anymore. some i see that we are actually in the wizard of oz land given the parallel universes we appear
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and, mr. weitzman and most of those on the democrat side think things are great. you apparently, although you did apologize and you have said it is an debacle, you also seem to think that the affordable care act is great. while myself and others have a different view. last week when the contractors were here, i focus my attention on the apparent lack of privacy in the website. if we will put up the first slide that i had last week, if we can. this is what is public, madam secretary. it is basically a disclaimer that says that any unauthorized attempts to upload information or change information on the website is prohibited. it really does not say anything about privacy.
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but you do have to accept that in order to go forward with the application. the next slide shows what is nonpublic. code.s in the source we try to determine this morning if it was still in the source code, but it has been pointed out the website is down. what i wouldmore say frightening to me. it says you have no reasonable expectation to privacy regarding any communication or data transiting stored on the information system at any time and for any lawful government purpose. the government may lawfully monitor, search, intercept any data transiting or stored in the information system, any information of data transiting or stored in the status of some may be disclosed or used for any lawful government purpose. -- cheryl campbell said she was aware of it but said that it was not her responsibility to put that in the source code. were you aware of it?
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was it your response ability to put this in the source code? >> mr. barton, i did not put things in the source code. i can tell you it is my understanding that that is boilerplate language that should not have been in this particular contract. the highest security standards are in place and people have every right to expect privacy. >> alright, ma'am, the last time we could check, this was still there. you are given almost unlimited authority under the affordable to administer it. will you commit to the committee and to the american people that one, you do want to protect their privacy, and two, you will take this out, fix it, make sure that it does not have bearing on people that try to apply through the website? >> yes, sir, and we have had those discussions with cgi, and it is underway. i do absolutely commit to protecting the privacy of the american public, and we have
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asked them to commit -- to remove that statement. it is there in error. needs to be taken out, and we should be held accountable for protecting privacy progressed thank you, madam secretary. i sincerely appreciate that, and i'm sure the american people do, too. my last question, or it is really a comment. hr 3348 says let's make the system voluntary for the first year since we are having so many problems and let the american people decide. what that means is if people choose not to birds of a, they would not be charged a participate -- a penalty for not participating. would you support such a reasonable approach to this while we work out the problems in the system? >> no, sir. >> well, that is an honest answer. quite the gentleman's time is expired. the chair will recognize the gem from new jersey, mr. boulogne. -- the gentleman from new jersey. whites to eye, mr. chairman. i do not believe we are in kansas, but i do believe we are in august because what i see
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here. comment fromf oz" a colleague from texas is particularly apropos because of what we hear on the other side of the aisle. i do not know how you keep your cool, madam secretary, with the part on the gop to sabotage the aca, to scare people and bring up red herrings, and i think that this privacy issue is another red herring, and i'm going to ask you a question about that, but before that, i just wanted to say -- this whole idea that is being brought up today that somehow, you know, policies are being canceled and people don't have alternatives is just another red herring. what i think my colleagues on the other side forget is that this is not socialized medicine. this is in fact private insurance in a competitive market. if i am an insurance company and all of a sudden everyone else is selling a better policy with better benefits at a lower price, i can't continue to sell a lousy skeletal prop -- policy that does not provide benefits
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and cost more because i will be out of the market. here.s what is happening the insurance companies are canceling lousy policies with high prices because they cannot compete. that is what is going to happen when you have a private insurance market, which is what we have here. we do not have a government- controlled system. we have private market. i just wanted to make a point. but i have to draw them on what mr. barton said here. before reform, the individual insurance market was dysfunctional, premiums would shoot up if people got sick, their coverage could be canceled if they had a pre-existing condition, and they did not have secure quality coverage. i have heard my republican colleagues saying that patient health information will be at risk in this application process, and this is flat-out false. in fact, the aca makes a giant leap forward for protecting information by taking a completely out of the insurance application rises, by banning discrimination based on pre- existing condition. is raising this red herring just like the
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cancellation of insurance by talking about privacy. madame secretary, prior to the aca when people up light for insurance coverage, and did insurers make them provide a long detailed invasive that all history now because the law bans discrimination based on pre- existing conditions, individuals not have to provide this information in their application. regardless of this clause, please comment on the privacy issue and why it is irrelevant. e, and that, any individual american who was in an employee or-based coverage, and government covers like the ones we enjoy, and medicare, and , and wholehe va righty of plans, that is about 95% of insured americans had no underwriting protections. thateople who were outside consumer protected space where individuals buying their own
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coverage in an individual market. medical underwriting demanding health records and often going through extensive dr. interviews and getting health records was a standard. pricing could vary widely -- could very widely depending on depending on health condition. that is the market that is currently being performed with consumer for texas. if a person had a policy in place in march of 2010, like a policy, and the insurance company made no changes to disadvantage the consumer, those policies are in place. you keep your plan, you like it, and that was on parent for the people -- and that goes on. for the people who had an underwritten policy who are paying more than their neighbor because they happen to be female could not get their health intention -- health condition written in. they will have a new day in a very competitive market. 25% of the insurers are brand- new to the market, and they are offering competitive plans.
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>> mr. chairman, could i just ask that this document -- >> sure, put it in the record, without objection. the chair will recognize mr. hall. >> thank you, mr. chairman. thinksecretary, i congresswoman brattle -- asked about the money. they're spending money as we speak, aren't they? problems.ted ongoing >> i'm sorry, sir, i am having a hard time hearing. what with the -- >> she asked you how much it has been today, and i'm asking you how much you expect to pay in addition to that on repairs of the website is going to require and they are requiring them as we speak here. those are things you projected, you knew they would happen, and they will happen, but you surely looked ahead and you have some estimate of what is going to happen. >> yes, sir.
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contractors,ajor subsidiary ofa united, and for cgi, there are obligated amounts. for cgi, who is in charge of the entire application, there has been 197 million dollars obligated, and that is to last through march of 2014, and as i said before about $104 million has been expended and that obligated amount. to be hereng to try on 2014 to be sure that your testimony is correct, ok? i'm just joking with you. [laughter] >> ok. >> were you born in kansas? >> i was born in cincinnati, ohio. i married a kansan and went to
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kansas. >> all right. i was in the third grade there and i thought i saw you on a tricycle there one day. [laughter] pre-k's well, it was an illusion. --let me ask you question have you ever rejected a financial bill from one of the contractors? >> have i ever -- >> rejected a financial bill from one of them. -- our accounting office of a routine audit and review of every bill that comes in before they do it. i do not personally. i want to be very accurate -- i do not personally pay contracts, negotiate contract feared by live by precedent, that is really legal for someone who is not a warranted contracted officer to engage in a debate or discussion around federal contracts. and missch is the ration spent on the exchange is in total, not just but all of the
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exchanges? how difficult is that figure to give me, or if you cannot give it to me, -- >> i would like to get it to you in writing very quickly. secretary, -- madame secretary, i would like to tell you about a couple of businesses in my district who are struggling with how to move forward. in manufacturing, one is in penetrating feared one has 185 employees, one has 56. the situation we are in is we have faced $170,000 in penalties under obamacare. this is another example of the government picking the winners and losers. we are the losers. there is no way i can be competitive if i have to raise my prices to cover 170 thousand dollars. here are my options -- do not pay the penalty, raise my prices and go out of business, 85 people go out -- loser., layoff 35 employees, move more production to this company, reduce 35 jobs. here is a quote from the other -- since they are high labor, no
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margin business cannot say to -- cannot afford to pay for insurance for our employees, we are faced with living our business through brinker at sea. there are heavy obligations that will continue whether we operate or not. firing of employees to get under 15 employees, even if we close the location, we cannot escape many expenses such as rental agreements. what am i supposed to tell these people? in the i think that employer market, 95% of all american businesses are exempt ,rom any kind of requirements cover employee insurance. there are outside the law. they continue to be outside the law, but they will have some new options for those who want to cover their employees and some new tax credit possibilities. for large employers, but 96% of them already cover their employees. as you know, the penalty that your constituents refer to is
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not a penalty that is imposed in 2014. it is being discussed with businesses about what kind of information is exchanged. quite the gentleman's time is inspired. >> he is going to use the gavel on me if you do not touch. >> the chair would recognize the delay from california. >> thank you, mr. chairman third welcome, madam secretary. you are a distinguished gentleman -- general woman. -- woman. and now working for the american people, i salute you for it. i want to really congratulate my republican pals for being absolutely, 1000% insistence. you love what is wrong with the website, and you'd assessed what is working in the affordable care act. i think that that is on full display here.
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but let's get back to the website because that is what the hearing is about. understanding that is a hard date for having everything up and running. now, hhs did- testify in september that they were 100% confident that the site would be launched and fully functional on time on october 1. that cannot work. do you have full confidence in this new hard date? >> congresswoman, i can tell you that the assessment that we have made is that it will take until the end of november for an optimally functioning website. i know that the only way i can restore confidence that we get it right is to get it right. so i have confidence, but i know that it is not fair to ask the
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american public to take our word for it. i have got to fix this problem, and we are underway doing just that. >> but are you confident -- i think i said november 31, which is -- does not exist. november 30. do you have confidence in november 30? >> i do. >> is there any penalty to qssi or cgi for not delivering on what they promised? >> i think it's you can see, we obligated funds for a contractor and we certainly have not expended all those funds. cms team not only the but our contractor partners to fulfill their obligations -- >> if they fail to fulfill their obligations, i do not know what is in the contract, is there a penalty? >> there is not a built-in penalty, but i can tell you that paying for work that is not complete is not something that we will do. si has taken on a new role as
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integrators of the hub that they operation ise in working extremely well not only for the federal changes but all the states based markets are using the hub, and that's why we have confidence in their ability to actually take this next role on and coordinate the activities moving forward, which has to be ofven with a very clear set outcomes, very accountable timelines and deadlines, and they will be helping to manage that process. >> on the issue of security, there was a security breach that arose recently that i read about , at any rate. very important here because the issue of policy was raised, and i think that has been answered, very importantly there is not any health
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information in these systems, but there is financial. -- hasuestion to you is a security wall been built? and are you confident that it is there, and that it will actually security financial information that applicants have to disclose? >> yes, ma'am, i would tell you that there was not a breach. there was a blog by a sort of skilled hacker that if a certain series of incidents occurred, you could possibly get in an insane -- and obtain somebodies -- >> isn't that telling? >> we immediately corrected that problem. it was a theoretical problem that was immediately fix. i would tell you we are storing the minimum amount of data because we think that is very important. the hub is not a data collector. it is actually using data
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centers at the irs, at homeland security, as social security to verify information, but is sourced on of that data. >> thank you. >> the gentlelady's time is expired. the chair recognizes mr. simpkins. >> thank you, mr. chairman. welcome, madam secretary. gave nohington post" deals on this whole debate of if you like the insurance you have you can keep it. would you recommend to the president that he stopped using that term? one at that be helpful in this debate? >> sir, i think he used the term at the time that the law was passed -- >> and as of september 26 also. wife that is why we wrote -- >> so the answer is you do not believe with -- we were headed down to user you can see it. have you ever shop, i know you have, but this is for -- at a groceries or with a coupon?
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have you ever used a coupon? >> yes. >> the coupons gives you the terms and conditions of when you go to the checkout to get whatever is off the price of the goods. sea you all added in the plans now option, you in essence give the searcher a coupon based upon what they are seeing there, the desire was let people know what the prices. reported,s the news and i followed up in last week's hearing, was that if you are under 50 years old, you get quoted the price of someone who is 27. if you are older than 50, could be 64, you get quoted 80 price of someone who is 50 years old. -- a price of someone who is 50 years old. isn't that misleading? >> the learned side of the website -- >> so that is truthful
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then -- >> it is clearly a hypothetical situation -- >> on ec plans now option, are you saying that is a hypothetical? it says this is the price we put in your age, and if your age is 49, it quotes you as if you are 20 -- as if you are way seven. >> the only way someone can get --actual -- an accurate >> let me ask you another question. when did you decide to use this below 50 ads 27 and above 50 at 50 years old, when did you make that decision? >> that was decided by the team -- >> by who? wholeoblem with this debate is you will not tell us who made the decision. >> i can tell you i did not design the site eric rice who made a decision on the 27-year- old quote for someone who is 50? >> i just that i would be that information.
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>> because it is misleading and the white house insists it did not mislead the public, and the we find that you did, let me finish on this debate, another transparency issue. if someone, a constituent of mine or someone in this country has strongly held pro-life views whack here we go. -- views -- >> here we go. >> can you make sure that is clearly identified and so people can understand if they're going to buy a policy that has abortion coverage or not? because right now, you cannot make that determination. >> sir, i do not know. i know exactly the issue you're talking about. i will check and make sure -- >> here is our request. can you provide for the committee the list of insurers and the federal exchange who do
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not offer as part of their package abortion coverage? >> i think we can do that, sir. >> you should be able to do it. >> i just said -- >> you said if we could do it. >> i think we can do it. wi-fi think or i know we can do appeared >> sir, i cannot tell you what i don't know firmly right now. i know that if the plan. i will get that information to you. >> the tournament time is inspired. the chair recognizes mr. angle from new york. >> thank you, mr. chairman, madam secretary. i appreciate you coming here to answer your questions about the affordable care act. these remind me of the story of chicken little over and around yelling the sky is falling, the sky is falling. unlike chicken little, my republican colleagues are actually rooting for the sky to fall. republicans are holding this hearing today under the auspices
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of an investigative hearing as if they want to get to the bottom of what went wrong with the website in order to help fix it. but i don't think, madam secretary, there is one person in this room who is naïve enough to actually think that the republicans want to see this law work. they voted over 40 times to repeal the law, they shut down the government and threatened to default in order to stop it. they are rooting for failure. that of secretary, can you tell us what would be the impact on americans health-insurance if republicans had been successful in their efforts to defund or repealed the affordable care act ? well, i think the estimates of the congressional budget office is that it would increase $110eficit by about billion in the first decade in close to $1 trillion in the second decade. we know that we have 42 million or 43 million americans without health insurance at all. some of them medicaid eligible and some over the medicaid
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eligibility. 30 governor so far, republicans and democrats, have the squared -- have declared their support with moving ahead with medicaid expansion, but after that, the affordable care act, those folks would be without any kind of health security. in the private market, what we know as it takes a real toll, but i would say the biggest issue is not just a financial toll, not just a community toll or the country tour, which is significant. i have a good friend who runs the cancer center at the university of kansas, i was with him and cancer researchers recently, and he said if you get a cancer diagnosis, you are 60% more likely to live five years and beyond if you have insurance than if you don't. i think that is a pretty powerful statement for why we need affordable care that's affordable health care for all of our citizens. >> thank you. republicans have not been able to define or repeal it, but they have denied requested funding, they raise argument about the
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and socialized medicine, and they were to intimidate groups that were to help the effort. they are spreading misinformation about the cost of covers. and to actively dissuade the uninsured from seeking coverage. madam secretary, how are these tactics impacted your ability to implement the affordable care act? >> i don't think there's any question that a lot of people need a lot of information. i think it is one of the reasons we had millions try to visit the site. it is why i am so frustrated and disappointed that the site is not fully functional and why i am so committed to getting a functional because clearly there is a demand. get information to people about the law. this is the law. this is not any longer a debate. it was a law passed by both houses of congress, signed by the president of the united states, upheld by the supreme court. the president was reelected. it is the law. and people have benefits and
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rights under that law. we have got to get that information so they can make good choices for themselves and their families fared >> well, thank you. it is the law. and frankie i find it disconcerting that my republican colleagues have done nothing but root for this law to fail for the last 3.5 years, and now there is a big show here of being upset, problems with the website. keeping people from signing up for covers fast enough. i wouldn't say to my colleagues on the other side of the aisle -- i would just say to my colleagues, you are on the wrong side of history. the website will be fixed and millions of americans will be able to get quality affordable health insurance coverage through the affordable care act. again, i thank you for being here today, madam secretary. >> mr. fits, chairman of the health committee. >> thank you, mr. chairman. madam secretary, have you personally try to enroll on the website? >> sir, i created an early light account so i would see the prompt that were coming to
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people who were interested. to theork my way applications feature fairly early on, but frankly i have affordable health care -- >> no, i just wanted to know if you had been through the process that's millions of americans are having to go through. madam secretary, the initial website grass -- crash is largely the decision to rent browsing of the plants. cgi federal testified at a hearing that they had designed the website to allow users to plans beforempare having to create an account. ms. campbell told us that two weeks prior to the october 1 launch am a they were told to turn off the browsing feature. were you aware in september that this is vision was made? not aware of that particular decision that was made of the cms team. i was aware that some features would not put additional risk on the website.
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>> who made the decision? >> administrator tavener made that decision. >> and do you know why that was made? >> yes, sir, because we were anxious to get the website up and running and functional, which we clearly have failed to do, to date, although i would suggest the website has never crashed. a veryunctional, but at slow speed and very low reliability and has continued to function. having said that, they pared down some of the features, feeling that it would be better to load them in later. one was the shop and browse feature. another was the spanish version of the website. andy medicaid transfers. all three of those issues were pared down to not load the system. quite thank you. lastly, cgi federal and qssi testified at the mess was response will for into and, and they believe that much -- that
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months of testing was credible to two weeks. do you think two weeks was enough time to complete testing of the entire system t? >> clearly not. >> when we made aware of the result of the test? october 1 up to the date, we had regular meetings cms, butonly a team at administrators involved. i was made aware that we were testing, and as we found problems, we were fixing those problems. i think there is a cgi reports made a august identifying some problems in between august and october, it was response will for cgi to fix those problems third that is why you test. quite a few "washington post" -- those problems. post" -- "washington
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urged agency officials to not launch the site because it was riddled with problems third were you aware in september that insurers had recommended the delay? wife i'm not aware that they recommended delay. everyone was concerned that there were risks and there were likely to be problems with the brand-new, an accredited insurance it's a not think anyone ever estimated the degree to which we have had problems in the system and certainly the contracting partners did not. did hhs responded to the reclamation to delay the launch? and was not in the meeting, i do not know who they talk to. >> can you find out the answer to that question for us? wi-fi will get back to. >> -- >> i will be back to you. >> thank you. thank you, mr. chairman.. >> thank you for being here today -- mr. green. >> thank you, mr. chairman., and thank you for being here today. we have one of the highest rates
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of people who have jobs but don't receive their insurance through their employer. it is for this reason that i believe houston would be a good place for you to come and spread the word about the tremendous benefits of the affordable care you werever we learned unable to attend because of scheduling conflicts, and we hope you can have an agreement that you will come to the fourth-largest city and probably have the highest number of uninsured in a metropolitan area. of course we are in the state of texas, which has the highest number of uninsured in the country. it is important to me and our constituents to get it right, and that is why i share your and the president's disappointment that the website is not working as planned. november 30 not soon enough. me and my constituents have been waiting for years to be able to purchase health insurance, and we are we to him to get the marketplace is up and running. the contractors have not served our country well, and should fix it or not be paid. now we are hearing about the cancellation letters being sent by insurance companies, customers notifying them that
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their plans are no longer offered third are these americans losing their health care coverage because of the affordable care act, or is it because these clans were changed after the enactment of the act? >> i would say the latter, sir. if the plan was in place of the enactment of the arts, no one would have received a cancellation -- >> so someday in america had an insurance plan before the act, the president was correct. if you like what you had, you could keep it. the plans were changed, and now they have to comply with the new law. >> they could either choose to be grandfathered and keep the same plan, which meant the same benefits and actually the regulation allows insurance medicals to charge inflation, plus the trendline, so they do not have to charge the same price. they could increase it. they could increase co-pays, they could increase coinsurance heard what they could not do it cancel benefits that the policyholder relied on. they cannot disadvantage the policyholder. but if that plan is in effect, absolutely it is still in effect. >> ok, but some of these
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millions of letters we are hearing about are probably because their plans change. >> absolutely. in the individual market, plans change every year. insurers -- >> even the small business market that happens. these plans are not allowed now because they're completely inadequate. they do not offer the minimum essential benefits. is that correct? >> that is correct. and ia state legislator know as governor in kansas, i assume every state has some type of minimum mandated benefits that they have for their health insurance plan to write they do, but it applies again, sir, any the past, usually to the group markets where 90% of covered americans get their policies. this market has always been the -- >> americans receive those letters from the companies about cancellations. they are eligible to purchase plans on a change. >> or out of the exchange. individuals who are not interested in some kind of financial help to go outside of these change on inside of the exchange. their insurer can offer them
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plans. they have choices they never had before. >> because of the affordable care act, 80% of their premium dollar will come back to them. >> that is correct. >> i know that it's not true in texas, but i do not know what any states that have that 80% requirement. >> well, no state had it. i would suggest in that kind of broad-based, prior to the affordable care act -- >> let me give you an example of a plan i found out during casework. a large company provided $25,000 maximum benefits for their employees in a year. most employees did not know about it. until this one constituent found out that she had cancer. the bill ended up being $300,000. that is some of those plans that are not being allowed to be sold out, is that correct? >> not only with the plan have a limit on out of rocket costs per year, it would have a limit on a lifetime out-of-pocket costs and it will take away the notion that you would run out of your coverage in the middle of a
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treatment, with a lot of fans i know i am out of my time, but it is like buying a car. if it looks good but is not have a motor, that is why the -- >> save a lot of gas by -- >> the gentleman's time has expired. the gentleman from new orleans, mr. walden. >> thank you, mr. chairman. madam secretary, we are delighted to have you. i hope you can appreciate we are trying to understand what we missed along the way, and one of the things that bothered me was the letter that was sent from back inncy to the gao june 6. i will read in part, it said we are in the final stages of testing the i.t. infrastructure, will support the application and enrollment process. hhs is extremely confident that october 1, the marketplace will open on agile, and millions of americans will have access to
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affordable quality health insurance. guy from an average oregon, and when i read i come it tells me you believe everything is good to go, the testing was in place, and we should have full confidence everything would work, correct? letter i signed, yes or -- >> actually, it was signed by your assistant. i went into this thinking things were ready to go, we should have full confidence, because when someone uses the words extremely confident, it tells me we are extremely confident your second piece -- when we had the testimony from the witnesses last week, i asked them about the into and testing, and what the industry testing -- standard would be, and they said it really should have been months, especially for a project of this magnitude, yet we heard it was two weeks. now, in august, gci told cms in the report -- >> cgi -- >> i am sorry, cgi, thank you. on august 9 that there was not enough time to conduct adequate
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performance testing. did that make its way all the way to you? and do you think there was adequate time? >> sir, clearly, as i have said before, we did not adequately do and to end testing. the products were not locked and loaded into the system until the third week in september. each of the component parts was tested, validated independently -- >> i'm sorry, all of those work, though, right? they told us last week that their individual models were tested and met specifications your to do you concur with that analysis? >> i do concur with the testing that was done, yes. >> so it really was the end-to- end, which is why some of us thought it should be delayed to avoid this very collapse that is now upon us. i realize not everybody agrees with that. the second piece here gets back to the "washington post," which i realize you have not had a chance to read this morning, but
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the note about the president repeatedly saying if you have a plan you will keep a plan. we all heard that to mean i have got a plan with a company, i will continue to have it even if they make minor changes, when in fact your own rules as written said no, that is not really what is going to happen. if minor changes are made, that means the plan changed, that means you do not get it. >> sir, that is not true. not say what you just suggested, and i think the estimate given that there would be turnover in the market was really an outside projection. it was on our rules. it was a snapshot of what happens in the market. lance change so dramatically over time that the estimates was that they would not be -- not because of our rules but because of insurance companies -- >> but you set up those market rules, looked like they had to comply with, correct? pre-k's only if they chose not to grandfather the policy. >> but that meant economic a change -- >> any grandfather would still
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be in place there >> right, but if they made any change -- changes in can make prices, they can make changes in benefits, they could not dramatically disadvantage the consumer, but they could have trendlines, they had a wide corridor to make sure that a similar plan, so if a consumer like the plan, the plan, if it stayed -- practical what the implication, i have letters from constituents all over my district who have gotten letters from their insurers who say because oh obamacare they are no longer going to be in the individual market or a lease with that lame in the invented -- in the and visual market, and they were saying they were paying 3 -- six underdogs a month, now it will cost me $800 a month for a $5,000 deductible. i've got others i will put in the record. a woman whose job, she had 40 hours, now down to 29, neither has health insurance because of the way this law is getting
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emblem and appeared i realize my time is expired. the gentlelady from colorado, mr. get. >> thank you, mr. chairman. thank you, madam secretary, for being here today could i want to follow-up on questions that mr. wallin was asking you about cgi. chairman issa release a document, monthly project status report from cgi last night, and it looks to me, it is sort of a technical document that has a list of outstanding open issues. some of them do highlight items that upon first read thing to be alarming. for example, one of the entry said due to the compressed schedule, there is not enough time built-in to allow for adequate performance testing. this certainly, in retrospect, sounds bad. but the day of the documents that chairman issa released in september 6, and then on september 10, quattro days later, cgi came into this committee and testified under oath "cgi federal is confident
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it will develop -- deliver the functionality that cms has directed." we are trying to figure out, at least i'm trying to figure out, how cgi is now coming in and saying you know, we want everybody that this was not going to be ready, when they came in and directly told me that they would be ready to launch on october 1 third so it kind of raises a -- on october 1. it raises the question how these statements can be reconciled. one excellent nation is that cgi was lying to this committee. i think that is unlikely. another is that cgi thought that the items flagged in this report were like a punch list that could be addressed. here is my question to you, madam secretary, was a cgi telling your department the same thing that they told the committee on september 10, that the company was confident that its programs would be ready to
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? >> congresswoman, all of the contractors testified here in september, and again i think last week before this committee, and the testimony was fairly similar, that they were ready to go in september. last week ifed they had suggested that we should delay the launch date. each of them said no. >> so they never asked you to delay the launch date? >> they did not. frankly, i think it's not valuable at this point to do a lot of pointing blame, fixing the blame. what i want to do is fix the problem. >> and soda white-haired >> i need the whole team to move ahead. >> and soda white-haired >> i need the whole team to move ahead. i.>> and so do zientz has now committed
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he says these i will be available for the vast majority of users by the end of november. given what cgi told us, and you believes do that that is correct, do you believe it will be pretty much ready to go by the end of november? i do. we are making improvements each and every day. it is easier to use now than it was two weeks ago. it is way from where we needed to be. >> so it is not like it is all going to be fine by the end of november. it is beginning to improve already. process,a continuous as websites are cured faces are made on ongoing business -- basis. as we find issues, we are fixing them in real-time. >> and you are going to guarantee that people will have privacy when they go on this. >> absolutely. >> i want to say one last thing. i was on the "washington journal" program this morning where callers call in, and i had
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a man, max, called in, and he said he got one of the letters from the insurance companies that his insurance was canceled, so what he did was he went on to the website and he come under the federal insurance, and he found a better plan, and now he is going to sign up. is whathope that everybody would be able to do. i thank you, mr. chairman. >> mr. kerry. >> thank you, mr. chairman. the pleased to hear that website will be fully operational by the end of november. would you come back to our committee so that we could see if that is actually accomplished and what is the comp list? >> i will make every effort to do that. >> ok. and state governor commissioner and kansas. -- in kansas. i reached out to our state commissioner and governor and found out that they have absolutely no data about nebraskans who either try to
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enroll or an role. as you know, nebraska is one of the states that opted not to do their own exchange and rely on the federal exchange. it is interesting to me that neither our insurance commissioner nor the governor's office had any data abroad nebraskans-- about and enrolling in these plans. i also asked our insurance commissioner if any of the navigators, if they knew who the navigators were and whether they had to apply to the -- to be certified or licensed in essence like an insurance agent would be , and they told me they have no clue who has been authorized by hhs to be a navigator and work with people in nebraska. so this is concerning to me. i'm going to ask you a few
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questions along this line. first of all, do you have data on how many people in general in the u.s. have tried to enroll in a plan through this website? >> no, sir, we do not have any reliable data around in roma, which is why he we have not given it to date. >> or have any data on how many butle have tried to enroll because of the problems have not been able to -- you i met, i can tell with insurers last week, and one of the priority fixes is the so- called 834's, the document that to a an individual's name company and verify that. that is what the systems -- >> i appreciate that. the contractors, i asked specifically about the information of how many people have tried to enroll, and they say they do have those numbers. cannot tell us that because of a contract with hhs saying
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their gag on the information -- >> i would suggest the numbers are not reliable -- >> i was a wet, my question is going to be, though, will you on the record authorized them to give us those numbers and let us determine the -- >> no, sir, i want to give you reliable, come from the data from every state and from the federal organ place. we have said we would do that on a monthly places -- basis. you will have that data. but do not want to turn over anything that is not confirmed and reliable. >> but that's data out there exists -- >> i would tell you right now it accordingiable data, to the insurance company that are eager to have companies, -- customers, they are not getting reliable data through the system -- >> the number of people that if clicked on and try to get or enroll -- i am not asking about
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what they enrolled in or whether they came in and said they were 65 and were quoted something that should be a pretty reliable number. >> the system is functioning. i met with said that was the case. reliability of that data certainly flies in the face of the testimony from the contractors. i yield back. you, mr. chairman. thank you, secretary sibelius. mr. chairman. thank you, secretary sebelius for your presence here today and your testimony. while i, too, am frustrated with the flawed rollout of, i do appreciate your longstanding commitment to improving the heal i think it is important to note that in my home state of california, and other states as
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well, the new exchange marketplace -- to call it covered california. it is working. constituents are finding that rates are as much as 29% less than those they found in the marketplace last year. i am thankful my constituents now have this option. as i look at implementation nationwide, it seems clear to me that political decisions in individual states have really made the difference for consumers. the governors and state legislators that embrace this law are delivering for their communities. who continue to throw up roadblocks here in congress, and state legislators, should not now be surprised there are significant bombs around the way. this seems to me to be completely disingenuous. having embraced the law since open enrollment began october 1, the fortunes have started nearly 180,000 applications, with --
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californians have started nearly 180,000 applications, with more beginning every day. i want to mention a conversation i had just last night with a telephone town hall in the central coast of california. one caller i heard from was a mother from santa barbara. she wanted to tell us the story of her son. her son is 28 years old, and had been paying $425 a month for his insurance before the affordable care act. she was happy to report that he has already applied, through covered california, and found a policy that works better for him, and has all the essential health benefits covered which is former policy did not, and will only cost him $109 a month. this is significant savings for him. and this is a story that is being repeated, at least in california, often. story that's being repeated at least in california often. so there are millions of
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residents in many states who have now set up their own websites and marketplaces, and those states, tens of thousands of people are now, as we speak, signing up for coverage, and this is demonstrating that the affordable care act is working. new york and washington, over 30,000 people have enrolled, in oregon, over 50,000 people have been enrolled, kentucky, 31,000 people have been enrolled. we could go on and on. the success of the data exchanges, which is where this is meant to be implemented, shows how badly this law is wanted and needed, how much it will be of help of people who want quality, affordable health care. my three quick questions to you are this, madame speaker, what is your assessment of how this first month has gone in the states that are running their own marketplaces, which this congress intended that the affordable care act work? >> well, everything we hear from the state-based markets is that they are doing well. they have not submitted data
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yet. we, again, are working with them around a monthly schedule so that they will confirm medicaid data and enrollment data, and we'll see the real numbers at the end of the month and make sure that the -- they are available to the public, but everything we hear is that they see the same demand, they are eager to enroll folks, and that that is going smoothly. >> and what do you think this success shows about the demand and the interest for affordable health insurance on the part of constituents? >> well, i don't think there's any question that in spite of a series of roadblocks and blockades, and a lot of misinformation driven by about a $400 million marketing campaign last year, americans are eager to see what their benefits may be under the law, what their opportunities are, how to get health security for themselves and their families, and we want to make sure that they see those benefits. the website is one of the ways to do that.
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the call center, on the ground enrollment, personal outreach, are a variety of ways, and i would tell your colleague, mr. congressman, i'd be happy to get you the list of the nebraska folks who are on the ground. it's available easily. it's public record, so i'd be happy to send it to you, so you could share it with your health insurance commissioner and governor. >> gentleman from the great state of michigan, mr. rogers. >> thank you. thank you, madame secretary for being here. short time, get through some questions here, if i can. is it your testimony that every night to try to increase the functionality of the system you're hot swapping codes? my understanding between 2:00 and 4:00, write new code, put it into the system, yes or no? >> clearly, i am not hot swapping code. there is a technical team -- >> you are in charge of the operation that hot swaps code on functionality. you're trying to improve the functionality, yes? that happens every night, yes? >> no, i don't think it does
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happen every night. it happens periodically during the hours of 1:00 and 5:00, but it is not a nightly feature. >> great. has each piece of that code that's been introduced in the system been security tested? >> that's my understanding, yes, sir. and the testing -- >> each piece of that code has been tested? yes or no? >> i don't know, but i can tell you that security -- >> that's a much safer answer, trust me. >> security is an ongoing operation that as code is loaded, you need to retest over and over and over again. whether it's pretested, i can't tell you. >> you need to test the code. is the end-to-end security test been conducted since went live on october 1st, yes or no? >> my understanding is, there's continuous testing as the temporary authority to operate calls for. >> yes or no, has an end-to-end security test on went live, yes or no? >> i will find out exactly what testing they are doing. i know they are doing simultaneous testing as new code
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is loaded. >> are there any end-to-end security tests run after every new piece of code is put -- i'm not talking about testing the code, i'm talking about an end-to-end security test. >> i can get you that information. >> i can tell you they are not, and i'd be interested why not. if you go to tab two quickly in your book -- >> what book, sir? >> you have a tab there. if you go to tab two, right there. while you're looking, i'll read. dated september 27th, and it is to marilyn tavenner. let me just a couple of pieces here. "there are inherent security risks with not having all code tested in a single environment. finally, the system requires rapid development and release of hot fixes and patches so it is not always available or stable during the duration of the testing." secondly, "the security contractor has not been able to test all the security controls
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in one complete version of the system." and if you look in the first part, which is most troubling of all, it says, "due to system readiness issues, the security control assessment was only partly completed. this constitutes a risk that must be accepted before the marketplace day one operations." and so let me tell you what you did. you allowed the system to go forward with no encryption on back-up systems. they had no encryption on certain boundary crossings. you accepted a risk on behalf of every user of this computer that put their personal financial information at risk because you did not even have the most basic end-to-end test on security of this system. amazon would never do this. pro flowers would never do this. kayak would never do this. this is completely an unacceptable level of security, and here's the scary part, we found out after the contractors
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last week that an end-to-end test hadn't been conducted on security, not functionality, because if it's not functioning, you know it's not secure. your on going hot patches without end-to-end tests. the private contractors told us it would take a very thorough two months just for an integrated end-to-end security test, which hasn't happened, because you're constantly adding new code every night to protect the functionality of the system. you have exposed millions of americans because you all, according to your memo, believed it was an acceptable risk. don't you think you had the obligation to tell the american people that we're going to put you in this system, but beware, your information is likely to be vulnerable? would you commit today, secretary, to shut down the system and do an end-to-end security test so that these americans can have their information -- >> no, sir.
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if you read the memo, our testing, daily, weekly scans are going on. this is a temporary authority -- >> that's not what the memo says, number one, and number two, the contractors will tell you -- >> mr. chairman, point of order. i think the witness ought to be allowed to answer what was a speech by the colleague, because he's raised a lot of issues. >> if the gentle lady will quickly answer. does the secretary wish to respond briefly? >> sir, i would just say this document is a document signed by administrator tavenner, which discusses mitigation strategies for security that are ongoing and upgraded and an authorization to operate on a permanent basis will not be signed until these mitigation strategies are satisfied. it is under way right now, but daily and weekly monitoring and
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testing is under way. >> mr. chairman, there are people using this system today and she's just admitted the system -- >> mr. chairman, she didn't admit that. you said it, she didn't say it. >> gentleman's time is expired. mr. doyle. >> thank you, mr. chairman. madame secretary, welcome. those of us who fought for this law, who voted for this law, have a vested interest in its success, and the concerns that you here expressed on this side of the panel are real, because we want to see americans get health care. i think it's somewhat disingenuous for my colleagues on the other side of the podium here to have this faux anger and this faux concern over a bill that they absolutely want to fail and have rooted for its failure and have voted over 40-some times to repeal this bill, never putting an alternative plan on the floor
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for the american people, but just to simply say they want to make sure this plan doesn't succeed. and i think the real fear is, that the plan will succeed and the american people will learn of the real benefits of this plan, not the propaganda campaign that's gone on by the republicans for the last three years. madame secretary, i think one of the keys to success of this plan is that we get young people to enroll in this plan. and i have some questions about some enrollment concerns that i have. now i understand that you've said approximately 700,000 people have applied for coverage via the and the state exchanges, is that -- >> they've completed an application. >> right. which is different from enrollment. >> that's correct. >> so my question is, are you expecting -- i know you don't have exact numbers yet, but are you expecting a large number or a small number of enrollments during the first month? what is your thoughts on that? >> well, our projections prior to launch were always that there would be a very small number at
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the beginning. we watch the massachusetts trend, which started slowly and built. i think there's no question that given our flawed launch of, it will be a very small number. >> yeah, i mean, in the massachusetts plan, i think the first month it was 123 people signed up, less than 1% of the overall first-year enrollment in the first month. and we saw the same kind of numbers in medicare part d the first month of open enrollment back in 2006. madame secretary, young americans are the most likely age group to be uninsured, and a lot of us are concerned because of the problems that we've been having with the website, that a lot of these young folks may not come back on, you know, they have very short attention spans. i've got four kids that all work on the internet, and if they can't get something in five minutes, they are on to something else. what do we do, and what plans are in place by your department to encourage young people to go back and revisit that site and
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to make sure that we're getting young people looking at that site and accessing it? >> well, step number one is fix the site, because we don't want people to be invited back and then have a bad experience a second time around. i think that's absolutely right. the site is particularly important to tech savvy younger generation folks who we need to enroll. i think that we have -- so fixing the site is step one, and step number two is getting information to folks that the law even exists. a lot of young people haven't followed this dialogue for the last three and a half years. >> yeah, i think we need a real marketing campaign, and we really need to reach out to young people. >> we intend to do that. >> especially at the end of november when you say this site is going to be working a lot better, to make sure they are checking that site out. >> you bet. >> one of my four kids is self employed, 33 years old, paying about $140 a month for a blue cross plan, he's eligible for a
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subsidy. we browsed that site. he's able to get coverage for about half of what he's paying right now, and that's good news for us, because i think my wife is paying his premium, so i think we're going to save the money. so i think it's important we had to prod him to go on that site and enroll, and i think for a lot of young people, they are not going to do it unless it's easy, so it's important we get that fixed. thank you. >> i agree. >> dr. murphy, chairman of the oversight subcommittee. >> thank you, madame secretary, and welcome. you had mentioned that the people who did the technology on the website made a number of mistakes, you mentioned verizon. last week they said it wasn't their fault they were told within hhs there was some problems there. >> sir, verizon wasn't involved in the website. >> with the data, i understand, i'm sorry. but they had a role, cgi had a role, other companies, et cetera. i'm just curious in this process, what decisions did you make that affected this for
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better or worse in terms of the data, the ease, or problems with the implement and being able to track how many people are actually enrolled? >> my decisions specifically to design the website, i was not involved. i am prohibited to choose contractors. we go by the federal procurement, and i got regular reports on exactly what was done. >> what about the part with regard to getting data in terms of how many people are enrolled or trying to roll, did you have any decisions in that process? >> the application process, to this point, does not work end to end very well. >> i understand it doesn't work. >> we do not have reliable data about the end of -- >> if you had asked them, look, i'm in charge of this, i'm going to want a regular report, how many people have tried to enroll, how many people have enrolled, did you ask that question? >> we have prioritized for our contractors that specific fix, and believe me, the insurance companies are eager for us to get reliable data to make sure
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their data matches ours, and that is not there yet. >> i appreciate that. i'm trying to find out if you told them that was part of the plan. real quick, we're hearing from thousands of people who have had their policies cancel, in fact, i heard from one insurer in pittsburgh that just cancelled 30,000 individual policies. they said they expect 50,000 to 30,000 to enroll in the exchange plans. just so you know, to date, so far, the number of people who have signed up for their plan is ten. ten. now i'm concerned a lot of these individuals and families aren't going to be able to make it by january 1st, so i'm wondering, do you know how many families will not have been able to keep their insurance by january 1st, do you have any matrix to help you understand what that is going to be? >> that has been in place at the state level, insurance companies must give their customers a 90-day notice about a policy change or a plan cancellation. >> i'm wondering if you have a mechanism whereby you will know if something built in this system -- >> i know if your constituents
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signed up for an individual plan, no. >> people across america. and do we know how many policies will be cancelled? is it 1,000, 10,000, 1 million, 5 million, do we know? >> we know that in the individual market, a number of of the plans having sold are not grandfathered and are not currently meeting the law. those notices have gone out. we know there are about 12 million people in the individual market. a number of them have grandfathered plans, a number of them have plans which meet the essential health benefits. >> let me put a face on that. person named paul wrote to me, i'm supposedly one of the families this act is supposed to help, but, in fact, is hurting more. we'll have less money for food and other essential items. i have a wife and four children to take care of. another person wrote, "i received -- i had a 2013 plan which if you include the premium, total liability was $5,300. for 2014, the same program liability is $9,000."
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single mom writes, i'm one of the millions having their health insurance cancelled because it does not meet the standards of obama care. i liked my insurance, now i'm being forced to sign up for something that will be way more expensive. as a single mom self employed, i'm worried about how i'm going to pay my bills. i hope you have a mechanism to track who these people are. she's not eligible for other subsidies, but the costs are going to be driving her down. >> sir, again, i would suggest there is no requirement that any of those consumers sign up for a plan suggested by their company at a higher price. they have now options. >> but if a plan changes -- >> health underwriting, without preexisting conditions, with some guarantees around -- >> she's searching around and she can't find a plan she could afford. she can't find a plan she can afford. >> gentleman's time expired. gentleman from north carolina, mr. butterfield. >> mr. chairman, before my time begins, i have a parliamentary inquiry. >> go ahead. >> mr. chairman, i'm always
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sympathetic to committee decorum and i want to ask unanimous consent to display the democratic twitter handle. >> go ahead. >> hear no objection, thank you. secretary sebelius, thank you so very much for coming today. i would like to ask you about the document that my republican colleagues have just released. this document is an authority to operate memorandum to operate the federally facilitated marketplace for six months and implement a security mitigation plan. this document, as i understand it, describes security testing for it says that security testing of the marketplace was ongoing since its inception, and into september of this year. in fact, it says that, "throughout the three rounds of security control assessment testing, all of the security controls have been tested on different versions of the system." that's good news.
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but the bad news is, that it goes on to say because of system readiness, a complete security assessment of all the security controls in one complete version of the system were not tested. this document indicates that cms postponed a final security assessment screening, but in its place, cms did put in place a number of mitigation measures, and it concluded that these measures would mitigate any security risk. question, are you familiar with this document? >> yes, sir. >> is it correct that this document recommends implementing a dedicated security team to monitor, track, and ensure the mitigation plan activities are completed? >> yes, it does. >> now is it correct that this document recommends monitoring and performing weekly testing on all devices, including internet-facing web servers? >> more than recommended, it's under way. >> is it correct this document
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recommends conducting daily and weekly scans? >> yes, sir. >> does this document recommend conducting a full sea test on the marketplace in a stable environment? >> yes, sir. >> is it correct that this document recommends migrating the marketplace to cms's virtual data center environment in the first quarter of next year? >> yes, it does. >> my understanding is that an independent security expert, the miter corporation, is performing security testing on the code that powers the website on an ongoing basis, is that correct? >> that is correct, and mitor did an assessment of the system, gave us a preliminary report, they are in the process of posting their final report. that did not raise flags about going ahead, and the mitigation strategy was put in place to make sure that we had a temporary authority to operate in place while the mitigation was going on, and then a permanent authority to operate
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will be signed. >> finally, do you have confidence in these and other measures you are taking to protect the security of americans' personal information? >> i do, sir. >> thank you. this is the third time you've said it during the hearing, and we believe you. thank you. what you're telling us is that these remedial actions and the ongoing security testing from mitor are protecting the security of the website. that's a message that it's important for the public to hear. my republican colleagues do not want this website to work. i am convinced of that. they want to block the aca at all costs and even shut down the government to stop the law. for the last four years, they have taken every glitch, every simple glitch, and hiccup in the law and tried to exaggerate its significance, and that's happening today and it's so disappointing. thank you, mr. chairman, i yield back. >> dr. burgess. >> mr. chairman, i wonder if i may make a unanimous consent request also? >> yes, go ahead. >> i would like to request
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unanimous consent my opening statement, which we were not allowed to be given could be made part of the record to this hearing. >> no objection. >> further, i do have a number of questions, many have come from constituents, i would also like to submit those for the record and ask the secretary for her attention to those so we can get answers, because they are, after all, important questions. okay, thank you, mr. chairman. it just came to my attention that on cnn, the cnn's website, that the site was hacked just last week, and i will be happy to make this available to you. i don't think -- >> the cnn website? >> the cnn website? >> cnn ran a story that the website was hacked last week. i would appreciate your response to that. mr. terry asked a question about he wanted to get the information about the number of people that signed up. you said you wouldn't provide that because it wasn't accurate woch . would you provide us with the number of people that have been able to enroll on the telephone? the president gave an 800 number
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during the speech. can we get a number of people that enrolled on the telephone? >> no, sir. we do not have reliable enrollment data. we'll have that you to by the middle of november as we committed to. we are collecting state data and telephone data. we're collecting paper data. we're collecting website data. we want it to be reliable. >> reclaiming my time, telephone doesn't seem like it would be that difficult to compile since the number is likely quite low. >> the telephone goes through the system. >> you have -- the president designated, i call it a glitch czar. you're familiar with his pintment to the -- i asked him to serve in this capacity, yes. >> many of ounce the subcommittee of oversight investigation were not as comforted as you by that selection. his history with this subcommittee is not great. he was involved with solyndra. we asked him to testify in 2011 and he refused requiring a
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subpoena. will you commit to making him available to our subcommittee for our questions? >> congressman, you're welcome to ask him to come before the committee. he is volunteering his services to us for a period of time. he has been appointed by the president to start in january as the head of the national economic council. he was the deputy director at omb for management and performance. i'm thrilled he is willing to take on this assignment and help us drive the management. >> again, his appearance here will be important. now, a lot of people are asking if the president's words leading up to this law if they matter. and the statement in "the washington post" today edited the president's statement, if you like your health care plan, you'll be able to keep your health care plan. if we deem it adequate. that seems like a more operational statement. especially if you go back just a few years into the federal register and i'm quoting from the federal register from july 23rd of 2010, just a few months
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after the law was signed, the rule -- the interrim rule for the dealing with the grandfathering written in the federal record because newly purchased individual policies are not grandfathered, the department expects a large population of individual policies will not be grandfathered covering up to and perhaps exceeding 10 million people. i hope the president was apprised of that before he made the statements. clearly his statement wasn't operational? >> again, that's an insurance company choice. that was a snapshot whast marof market looks like. it was employer-based coverage and individual coverage. >> but those were the comments that were recorded. now -- >> this isn't a government takeover of anything. these are private insurance plans. >> i do have to ask you this. you served at the pleasure of the president. we're all aware of. that but we've had many of your employees here in front of this
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committee. and do you have to ask yourself, are they being purposely misleading or are they really not that smart? so i'm going to ask you this morning for the sake of the future of health care in this country, will you please ask for the resignation of gary cullen because he misled us. >> i will not, sir. >> the gentleman's time expired. >> a point of personal privilege. i think the record ought to be clear about jeffrey science. he was invited with less than a week's notice to come before this committee. he couldn't make it that day. he asked for some other day. he went to omb and had nothing to do with the solyndra contract. did he come before us and talk about it. the sole role is to represent omb. i don't think he ought -- there ought to be any disparagement of him. he is a very wealth regarded public servant. >> the gentleman's public will stand.
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>> thank you, mr. chairman. welcome madam secretary. now we all agree the website problems must be resolved. this country invented and developed internet and the concept of the web sites. so there are high expectations. the fact that the hired private contractors didn't build the website in three years is inexcusable. i hope those at fault will be held accountable. we can't lose sight of the big picture that, when this is all said and done every american will have affordable quality health insurance and health care. this is a goalie believe of all democrats and republicans. the aca is working in california and is working in my district in sacramento. i just want to tell you about a letter i got from the constituents. dear congressman, as a self-employed contract employee i've had individually purchased health insurance for 11 years now. insurance that has gone up every year, sometimes more than once.
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insurance that wouldn't let me add my daughter when my sex husband stopped his insurance policy that covered them both. insurance that i underused for fear they would drop me. insurance that just dropped me anyway because they decided they will no longer offer individual plans. this could have happened to me at any time. i'm so grateful that the affordable care act provisions make it possible to get health insurance beginning in january for me and my daughter. as all this is happening, i have finished graduate school and started my own business. slowly but surely things are happening and i will be hiring my first employees in the next six months. the provisions of the aca are helping me in this, too. i can clearly see what would cost me to provide health benefits for my future employees, understand the costs and build my business plan accordingly. and that is just one of the letters i received. now, i've also heard from my colleagues on the other side of the aisle complain again and again about how health care
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reform is increasing health care costs. but the empirical evidence shows something quite different. the recent trends in medicare spending growth are really quite remarkable. medicare spending growth is at historically low levels growing by less than .5% in fiscal year 2012 following slow growth in 2010 and 2011. the same is true on the private side of health care. personal consumption expenditures on health care, everything from health insurance to drugs to hospital care rose by just over 1% in the past year. this is the slowest increase in nearly 50 years. madam secretary, what does this data tell us about what has happened to health care costs since the aca became law? >> well, you're absolutely right. in the last 3 1/2 years since the president signed at fordable care act, we have seen a great slowdown in the extraordinary
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cost increases year in and year out for health care, in the medicare plan and medicaid plan and in private insurance and in underlying health care costs which affect every american. some of that is to do with some of the features that are currently in place around different care delivery and different payment systems that we are helping to draw and given the tools we have with the affordable care act. more quality outcomes, trying to prevent hospital readmissions, looking at hospital acquired infections, medical homes that prevent people in the first place or help them stay healthy in their own homes and in their own places. >> so it's true that private insurance costs are growing at the slowest rate in decades. >> that's true. >> am i also correct that the aca premiums are coming in lower than predict by experts like the cbo? >> well, they're about on average about 16% lower than was estimated that those premiums would be and that's the premium,
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not accounting for the number of uninsured or underinsured americans who will then qualify for financial help since they don't have employer coverage, they get some help from the taxpayers paying for that coverage. >> thank you, madam secretary. >> thank you, mr. chairman. madam secretary, when you spoke at the democratic national convention in charlotte last september, one of first statements you made about the affordable care act was, "but for us democrats, obama care is a bad drama because no matter who you are, what stage of life you're in, this law is a good thing. first, if you already have insurance you like, you can keep it." i'd call this a red herring that misled voters intentional or not. now perhaps had you known that millions would lose their coverage, families would face financial disaster as one constituent recently told me.
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or that exchange rollout would be plagued by multiple delays we've seen. you would not consider it such a badge of honor. the fact is your words and those of the president as he came pained last year that if -- campaigned last year that if you already have insurance you have you can keep it seemed to be refuted by the millions of cancellation notices already sent to americans just in the past few weeks. whether your statement was inaccurate or as mr. hoyer said yesterday, not precise enough, it does strike me that millions of individuals who by listening to speeches like yours voted believing one thing now find themselves without coverage and are now scrambling to find coverage in a marketplace that offers more expensive plans with fewer options. in response to my constituents' calls for herngslp, i created a portal on my website, no patches
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forris or fixes needed. it allows them to tell me about their personal experiences. my office received dozens of complaints regarding increases in their monthly premiums. i received one such notice from a mother in her early 50s who just received a notice that not only will her insurance premiums double but she will also have to switch insurance to insurers to keep her doctors due to the fact of at fo of the affordable care act. i can tell you just in my district many more are experiencing this situation. madam secretary, this is akin to telling seniors that in a few weeks they're medicare coverage will be dropped. or their premiums will double. i know that neither you nor the administration would ever advocate for such a policy. yet, here you are subjecting those currently in the individual market to such government intervention. and i would hope that you would agree with me in recognizing that these increases are a heavy
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hardship on my constituents on all of our constituents, republican or democrat. now get to my questions. you know the health care law included a hardship exemption from the individual mandate. yet, the administration has failed to finalize the application form for the hardship exemption 3 1/2 years after we passed this law. as of today, can an individual apply for hardship exemption from the individual mandate on heal heal yes or no? >> i don't know. >> i do. it's no. on october 15th, politico reporting that if the on line system for getting into obama care is rickety, the system for getting out of the mandate doesn't even exist yet. hhs says it will take another month at least for the administration to finalize the forms for the hardship exemption from the individual mandate. why has it taken 3 1/2 years to
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finalize a simple application form for an exemption from the individual mandate? >> sir, as you know, the individual mandate is not in place until next year. we have made it very clear that if somebody is medicaid eligible in a state that doesn't choose -- >> my last question and my last second. 16 million people in the individual market have or will receive cancellation notices stating their health insurance coverage does not meet minimum coverage requirements of the affordable care act. it grants you the power to determine the criteria for hardship exemption. will you provide all of these individuals a hardship exemption since the affordable care act is taking away their plan? will do you that? >> no, sir. and i think those numbers are far from accurate. 95% of americans who have health
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insurance will be in a continuous plan, medicare, medicaid, employer based, va. 95%. 5% who are in the individual market, a portion of those 5%, a portion of them, about 12 million people, a fraction of those 12 million will have a plan that doesn't meet the criteria and has not been grandfathered in. they are indeed receiving notices. many of those individuals, half of them, will be eligible for financial help getting a new plan and they have many more choices in the marketplace. so we will not have a blanket exemption. >> sounds like a hardship to me, madam secretary. >> the gentleman's time expired. mrs. christianson. >> thank you, mr. chairman. and thank you madam secretary for being here and thank you for all that you and your staff at hhs has done in implementing at fordable care act to insure it provides the many benefits to children, women, to medicare
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beneficiaries and to ensure security to those who already have insurance as well as lower costs. of course, the biggest complaint has been about the application and the enrollment website. we have heard over and over from you that those are being addressed. but you would recall and i know my colleagues would recall that congressman rush and i have always been concerned about those who do not have internet access, those who are uncomfortable using the internet and would not use it. so i just wanted to just remind everyone that there are other avenues for enrolling either by telephone or by paper either alone or with the help of a certified application assistant. but my question goes to one of the rumors that is circulating. there many resume norz about how the affordable care act affected part time workers. some of my colleagues on the other side claim that the
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companies are moving workers to part time jobs because of the health care reform law and that low wage workers are being detrimentally affected. and i understand why these claims are being made as just another part of the on going effort to undermine the law. would you take a few minutes and just set the record straight on the part time issue? >> certainly. 95% of businesses in this country are small businesses, under 50 full time employees. and there is no responsibility that any of those employers have to provide health coverage for their employees. on the other hand, there are now tax credits available for some of the smaller employers who want to offer coverage to actually come into the marketplace. for the other businesses, the businesses hiring 50 or more, there is a standard that says an
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employee is considered full time if he or she works 30 hours a week. and that really came from a market snapshot with help from the small business administration of where employee benefits were in the private market based on hours of work. what was a part time or a full time employee? what we know about the economic data is the high point of part time workers was in 2008 and 2009 at the height of the last recession. it has been decreasing each and every year. there is no data to support the fact that there is an uptick based on the impending affordable care act. i'm sure that there may be some individual employers making some business decisions about how many workers they want full time and how many part time. but i can tell you there is no economic data or employment data that supports the notion that
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this is an effective law. >> in fact, it's my understanding, that part-time workers are at the lowest percentage of workers in many, many years right now. >> well, for the if i ever tifi part-time workers have options for affordable health care. they never had that before. they've never had options in the marketplace. they never had some health purchasing coverage for themselves and their families. their full time colleagues have but they have not. so they will have options. >> and just to be clear, i had another really long question. the last part of it, it would be fair to say that the every point along the way you expected this website to work based on everything that you have been told by the contractors up until that point. >> i expected it to work and i desperately want to get it working. >> more than anyone else, i am sure. and we are committed to fixing it.
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the only thing that i think builds back the confidence of the public is fixing it. >> thank you. >> gentle lady's time expired. >> thank you, mr. chairman for holding the hearing and thank you for being with us. last week when the contractors built the system were here, i asked them all under oath if they had actually delivered the system they were contracted to build. and all four of them answered yes. i want to ask you, did the contractors deliver the system that you contracted them to build? >> i don't think i can accurately answer that question. what we know is we've a system that doesn't function properly. >> we definitely know that. >> as we fix things, we'll know more about what is broken along the way. and i'll be able to -- >> so would someone in your office know -- someone oversaw the implementation and they said this is the product we contracted and paid hundreds of millions of dollars to build or wasn't. does somebody have the ability to get that information? >> we can say that products tested individually verified individually.
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>> but clearly was an integrated system. >> and don't work well together. >> but, you know, i used to write programs for a living. i develop software products for a living f you're developing a system, it's irrelevant if one component works by itself. but when you plug it in together it doesn't work, that's a system that doesn't work. one question i had and others had, somebody in your agency made a decision to change the system. instead of grog a browse area built where somebody on kayak or just like on could go shop for products, look at prices before they purchase, which is how consumers are used to doing this y'all made the decision to change it around and gather all the information first before you could let them see prices. was that you who made that decision? >> no, sir. >> was that miss taverner? >> yes. >> and a team that looked at -- >> did that team make that decision because once they saw the prices, and we're getting reports from all our constituents of dramatically
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higher prices than what they were expecting. did you make the decision because you knew that when they saw the prices they may not want to bite product so you wanted to gather the information first? >> sir, first i did not make the decision. i was informed about the decision. we didn't -- >> do you agree with the decision? >> it rolled off a number of features. they can see the products. there is no requirement to buy anything. >> i spent two hours to get into a system. i never once did get to a point where i can see the price and got the blank screen that's other people got. i want to share stories from some of my constituents. i -- we started a page on our -- on facebook and twitter and we're collecting share our stories. we're getting lots of stories from my constituents. i want to read a few of them. randal said my health care premium went up 30% to over $350 a month increase. we have michelle, our insurance premiums are going up $400 a month and our deductible
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increased. then you have shawn from could having ton, my current plan through united health scare no longer being offered in 2014 due to obama care. in fact, i received a letter stating that the new health care law was indeed the reason for the removal of my current health care plan. madam secretary, what you would tell shawn who liked his plan and now lost it? he was promised by you and the president he'd be able to keep that plan. what would you tell shawn now that he lost his plan? >> i would tell him to shop in the marketplace and out of the marketplace. >> do you really think that's acceptable answer to shawn. >> if united chose not to keep shawn's plan in effect for shawn -- >> because of the law. >> sir, the law said if you keep shawn's plan in place, if he liked his plan, if you only -- then the plan is still there. >> you and i may disagree over who you work for. i work for shawn. you work for shawn, madam secretary. shawn lost his plan that he liked. and there are thousands and
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millions of shawns throughout this country that lost the plan they liked because some bureaucrat in washington said we think your plan is not good enough even though you like it, even though you were promised can you keep it, you're now not able to keep that plan. i think you deserve to give shawn a better answer than you just have to go shop for something else even though you like your plan. >> the gentleman's time expired. >> thank you, mr. chairman. thank you, madam secretary for coming to day. i'm going to follow up on mr. doyle's line of questioning. one concern i have with the fallout from the website is that many users who tried to sign up and discouraged becausest proble of the problems will be too discouraged to come back once the site is fixed. what do you plan to do to get those folks to come back? >> sir, we intend to invite them back. formally by e-mail, by message. but we don't want to do that until we're confident that they will have a different experience.
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so fixing the site is step one. and then inviting people back to the site to make it clear that when our timetable is fulfilled, they have four months to shop for affordable health coverage on a fully functioning site. we know we're going to have to spend special time on young and healthy merns wamericans who thy don't need insurance, aren't aware of the law, don't want to use a failed or flawed site. we have to spend some particular attention on them. >> thank you. have the software spes infectioinfectio specifications including the test specifications, has that changed since the initial rollout? >> i know that there certainly are some changes because since october 1st -- i'm sorry. >> yes, since the rollout. >> the specifications haven't changed. we are certainly fixing, as i say, speed and reliance is one of the issues we're taking a
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look at. that's the performance side. but there also are some functionality sides that things do not work as they can including the enrollment passed on to insurers. so we're fixing functionality. i don't think that's a change in the specs. i think it is actually making the system work the way it should. >> well, are you -- is the department doing a prioritization on the problems? >> yes. >> can you describe that a little bit? >> yes, as of last week when jeff signs joined us for the short term project, we asked him to lead a sort of management team. we have pulled in all of our contractors as well as additional talent that they may have available. we have talked to tech folks in and out of the private sector and insurance, some of their
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tech experts to get all eyes and ears, made a full assessment, developed a plan for fixes along the way, have a punch list for going after those fixes and we are doing a daily tech briefing and blog to tell people what we have found, what we have fixed, what's coming next, what the functionality is and we intend to do that until it's fully functional. >> thank you. madam secretary, looking past the initial problems with the aca rollout, do you think that the affordable care act will be successful in bending the health care cost curve and reducing the fraction of our national economy that goes for health care? >> well, i think that we have already had some success. i think the goal is to continue to achieve that, fully insured population arguably with preventative care, an opportunity to see a primary care doctor and not go through
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the emergency room will in and of itself reduce costs. having people identified earlier who may have serious problems and managing those problems will reduce health costs. i think the delivery system also needs some considerable help in paying for a number of procedures, number of tests, number of prescriptions but paying for health outcomes. >> thank you, mr. chairman. >> thank you very much, mr. chairman and madam secretary, thanks for being with us today. appreciate your testimony so far today. what i'd like to do is i'll get these two you. there are so many -- these are questions that we've received from our constituents back home specifically about what's going on with the website and for them. so what i'll do, i'd like to get those two you. but there is a lot of questions here. a lot of thoughts gone into a lot of the questions. but if i could start with last week's testimony when our --
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four of the contractors were here. and in one of the questions that i had posed to miss campbell from cgi and her testimony she stated that they delivered the and were the sites more or less complicated than the site that we were talking about here today? and she said, of course, the site today was more complicated. and in the questioning and from her testimony, and we've been hearing about this testing that wasn't happening that we had individuals out there saying that about two weeks had been done, but i ask her about was there sufficient enough time when they did and the response she gave me back was on which is a less complicated site and she stated we had sufficient time to test the system before it went live. and i asked her in a follow up then, what was that sufficient
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time? and she said we had a number of months before the system went live at that time. and i just want to make sure because again, you know, sometimes things don't get reported accurately. and the "u.s. news and world report" on october 18th of this year and there is some questions going back and forth. i want to make sure that you were quoted properly. after two weeks of review, the hhs secretary concluded we didn't have enough testing specifically for high volume for very complicated project. the on line insurance marketplace needed five years of construction and a year of testing, she said, we had two years and almost no testing. is that correct? >> i don't know the quote. i never suggested that we needed five years. i don't know where that is from. >> that's one of the things we're going to check. >> we clearly ever didn't have five years. the law was signed in 2010. >> and then last week you --
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when you were down in texas you were being asked by a report bert system and the launch. and one of the parts of the question was that at what point did you realize the system wasn't going to be working the way that you envisioned before the launch and why didn't we stop it before the launch? and, again, this is what was reported. we knew that we had another six months we would probably test further. but i don't think anyone fully realized both the volume caused such problems but volumes also exposed some of the problems we had. now going back though to miss campbell's statement that they tested more extensively on a system that was not as complicated but hhs, cms decided to go forward with only a very short period of testing. do you think that was acceptable? >> clearly looking back, it would have been ideal to do it
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differently. we had a product that, frankly, people have been waiting decades to have access affordable care. medicare existed well before the website. it's a program that started 50 years ago. the website was an additional feature for consumer ease and comfort. and so they were not launching medicare. they were not delivering health benefits to seniors. they were putting together an additional way to enroll in medicare. i would suggest, sir that, we had deadlines in the law that people had benefits starting january 1st. we wanted a extensive open enrollment period so that a lot of people who were not familiar with insurance didn't know how to choose a doctor or choose a plan had never been in this marketplace or people who needed to understand fully what the law offered had ample time to do that. so the date that i was required
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to select for open enrollment, that's again part of the statute, how long would open enrollment be? we picked that date. all the contractors that began early in this process in the fall of 2010 when we issued -- i'm sorry, 2011 when we issued the initial contracts to cgi and qssi new the october 1st date. that was not changed. it wasn't added to as we got closer to system, one of the reasons again that we paeared down what needed to launch is an attempt to minimize the risk to the system to get people to their ability to see clearly what they were entitled to, what the plans were and if they chose to to enroll. clearly, the testing should have been longer, should have been more sufficient. >> gentleman's time expired. >> thank you, mr. chairman. madam secretary, people who are
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watching this hearing might be under the sum that is there is some kind of political debate going on over the affordable care act. i think people in iowa don't care anything about who's winning the political debate. they want these problems fixed and they want them fixed now. i think that's the responsibility of everyone in this room to make sure that that happens. i tried to go into the marketplace on october 7th and i encountered problems immediately dealing with the security code questions which required you to select dates. one of them was type a significant date in your life. today is my birthday. so i put that in. i tried three different ways of entering that date and got a message each time, important this is not a valid answer. same thing for the third date entry. and a lot of times when you're registering online for anything and you have to put a date in, there will be a little prompt that tells you what the format is you're required to enter.
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do you know, have we solved this problem in the security code area? >> yes, sir, one of the initial issues was just getting people into the site and the id proof clg is a two-step process, one is that you give some preliminary information and you set up a pass word. but the second to insure that your personal data can't be hacked, can't be interfered with is the second step where some personalized questions which only can be verified by you are indeed part of that. again, that was a -- an initial holdup in the system. we focused a lot of attention on that. the first several days it was fixed only to then discover that there were system problems throughout the application. and that piece has been fixed. i would suggest it also was a function of trying to make sure we had the highest security
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standards, that we were not cavalier about someone's personal information being able to be addressed and attached. it was a functionality that didn't perform properly. but it does now. >> one of the things that keeps coming up in this hearing because you are from kansas is references to the "wizard of oz." people went to see the wizard because of the wonderful things did he. the affordable care act is doing a lot of great things in iowa. the des moines register said that iowans buying health insurance will face the lowest premiums in the country. increasing competition in our state. iowa consumers are able to choose from 40 health plans in the marketplace. you've mentioned the growth of health care spending is at the slowest rate in 50 years. 50,000 iowa seniors received prescription drug rebates. bans on pre-existing conditions are allowing people to get coverage and switch carriers. and now insurance premium
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increases are subject to review and can be rejected by the people reviewing those plans. but all of these good things don't mean anything unless we solve these problems. and what i need to know is how confident are you that the problems will be fixed by december 1st? >> well, again, congressman, i have committed to that date because that is the assessment of both inside and outside experts have analyzed. i think they kicked all the tires and looked at all the system. i know that there's no confidence in that date until we deliver on the date. i'm well aware of that. and that's on me. >> since americans were supposed to have six months to sign up, would you support insuring they still have six months by extending the open enrollment period for two more months? at this point they would have a
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fully four months of fully functional always to sign up. again, there are alternate ways and the website right now that people are getting through. the open enrollment period is extraordinarily long. it's about six times as long as a typical generous open enrollment period. and it's important for the insurance partners to know who is in their pool so again they can stay in the market next year and know who they're insuring. so we think that the timetable will allow people four months time to fully use the website. they can use it right now. they can use call center. they can go to navigateors and enroll. >> the gentleman's time expired. >> thank you, mr. chairman. thank you for being theer day. i'm sure there are other things you'd rather be doing. but we welcome the opportunity to have this conversation. i'm going to ask the clerk to bring you a document for you to look at so i can ask you a couple questions.
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if can you go to page 8 on that, i have highlighted an item there. but this is a copy of a cgi slide show from october 11th discussing technical issues that must be addressed within the website. and on page 8 what i've handed you, cgi recommended that cgi and cms have a review board to agree on which issues can technically be solved and which should politically be solved. was such a review board convened? >> sir, i cannot tell you. i've never seen this document and i'm not aware of this recommendation. >> and cgi is responsible for the website, correct? >> cgi is responsible for the application. >> for the application. >> yes, sir. >> does it surprise you that in a slide show that they gave in october 11th they acknowledged political reasons for -- >> again, i've never seen this document. i have no idea what that means.
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did ask you cgi when they came last week? >> can you find out for us if such a review board was done and if any decisions were made on political reasons or on the other reasons and find that out for us? >> sir, i -- that question needs to go to cgi. i can ask them to report to you. >> this is their document? this is not our document. >> you would turn to page 9 of that document, please. it states challenges on page 9 that says under challenges, unable to determine at this time whether low enrollment counts are attributable to system issues or due to users choosing not to select or enroll in a plan. so those are two completely different issues, obviously. if it is the system issue, that's something you have confidence that at some point will be resolved, correct? >> yes, sir. >> and if it's a user selection issue, that's an entirely different story, is it not? >> yes, sir.
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>> okay. now, you know, when you use the phrase earlier about a punch list, that's like having somebody move into a house. someone's buying a new house and they go through and they have been told this house is going to be ready on october 1st. they load up the van, they come in and they get in and it's not finished. part of the plumbing is not right. the wiring is wrong. and they go in. this creates the situation where we -- health care shouldn't be a zero sum game. i mean we want to be fair to everyone. we want to help people who are vulnerable. but at the same time, we shouldn't have to hurt folks. we've got people in my district, in my state who are getting notices of cancellation. they're being told of higher premiums that they're having. and these are great concerns that we have. and how do we work through that? and i want to say i appreciate you accepting responsibility for
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these initial rollout failures that we've had. but who is ultimately responsible? it is the president, correct? >> for the website? >> the president is ultimately responsible for the rollout, ultimately. >> no, sir. we are responsible for the rollout. >> but who do you answer to? >> i answer to the president. >> all right. so is the president not ultimately responsible like a company ceo would be? >> sir, he's the president of the united states. i have given him regular reports and those -- i am responsible for the implementation of the affordable care act. that's what he asked me to do. that's what i'll continue to do. >> so you're saying the president is not responsible for hhs? >> sir, i didn't say that. >> so the president ultimately is responsible. i think it's great that you're a team player and taking responsibility, it is the president's ultimate responsibility, correct? >> you clearly -- whatever. yes, he is the president. he is responsible for government
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programs. >> my time expired. >> the gentleman's time expired. >> mr. chairman, thank you very much. bring begin, i'd like to ask unanimous consent to submit into the record some articles from new mexico publications, first entitled small business owner health exchange will save me $1,000 a month. >> without objection. >> i see my time did begin there. so i'll try to get through this, mr. chairman. madam secretary, i was inkritrid by a line of questioning asking about the individual marketplace. how volatile was the individual marketplace before the affordable care act became law? >> i would say it wasn't a mark marketplace at all. it was unprotected, unregulated, and people were really on their own. >> madam secretary, the kaiser family foundation reports have over 50% turnout of individuals that have coverage and individual market churn out coverage every year.
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they either lose coverage, priced out or drop it s that consistent with what you're aware snf. >> that's an accurate snapshot. about a third of the people are in for about six months. and over half are in for a year or less. >> so individuals that were in the individual marketplace before the passage of the affordable care act did not have the same protections as those in group coverage? >> that's true. >> and would those individuals in the individual marketplace sometimes have higher co-pays? >> higher co-pays, unlimited out of pocket costs for often coverage that was medically underwritten or excluded whatever medical condition they had in the first place. >> so these were typically one-year contracts. if they use the plan because they got sick nor a car descent or a victim of domestic violence, sometimes they would be thrown off the plans or rates would go up? >> yes. >> i think that's important to note, madam secretary. and i'm intrigued as well that my understanding is that last month hhs conducted an analysis
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that found that nearly six out of tun uninhere issed americans will pay $100 a month. >> they'll have a plan if that is their choice. >> and that number would be even ier, would be better if more states chose the option of using federal funds to expand medicaid to cover the low income population? >> that's just a marketplace snapshot. those are people that will be in the marketplace. >> madam secretary, i don't think i heard anyone from the other side of the aisle today, my republican colleagues, ask you how can congress work with you and support you in fixing this website and fixing this problem? i hope that we all agree we want this website fixed. i would yield to anyone that would disagree. seeing no one accepting that. i'm glad to hear that we agree with this. now madam secretary, what can congress do to work with you to fix this website? >> well, i'm not sure that there is hands on work that cyou can
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do. maybe we have some technical expertise, but i would say getting accurate information to constituents is helpful. letting people know that they can check out the facts in the law. that they may be entitled to some financial support. that cancellation of policies means that the policy that they had may not exist but they have a lot of choices of new policies and a law that now says they must be insured in a new policy. they don't have to be insured by their company at a higher price. >> i appreciate that. going back to the individual marketplace, madam secretary, did this congress in previous years before the affordable care act make it illegal for health insurance companies to raise rates on someone after they submitted a claim for going to the hospital or becoming sick? >> no, sir. >> madam secretary, one last note here. it seems that we received some horrible news that there are bad actors already taking place of
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fraudulent web sites that imitate the health care xlafrpg or misleading seniors into disclosing personal information. i signed on to a letter to you led by my colleague representative out of california to request that you prioritize fraud prevention efforts. what has the administration done to prevent the fraudulent acts? >> i can tell you, congressman, the president felt very strongly that that needed to be part of our outreach effort which is it why the attorney general and i convened representatives of state attorneys general, insurance commissioners, the u.s. attorneys and the justice department and the federal trade commission which has jurisdiction to make sure that we first got out ahead of some of this developing consumer outreach. no one should ever give personal health information because personal health information is not needed for the policies any longer. that's a red flag. we want to make sure that people turn over potential fraudulent acts. we have put training in place
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for navigateors. we have our law enforcement -- >> the gentleman's time has expired. i would just note that we -- with the indulgence of the secretary, we're hoping that we can have all members ask some questions but we also know that with four minutes we're going to have a little trouble. i'm going to ask unanimous consent that we try to limit our questions and answers to no more than two minutes. and i talked to mr. waxman. is that okay? because otherwise we will -- there will be a lot of folks who will not be able to ask a question at all. >> three of us. >> mr. chairman, i would submit that if the questions get submitted we would be happy to provide timely answers also. >> so can i do that? so with that we'll try two minutes. mr. lance? >> i guess i won the lottery on the two minutes, madam secretary. >> time has expired. >> 20 seconds, mr. chairman.
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on the website, madam secretary, the contractors testified last week that they needed more than two weeks for end to end testing y in your opinion was there not more than two weeks? >> again, we have products, the insurance policies themselves by companies. we're loaded into the system. so we could test up until then but it wasn't until september, mid-september that that was done. again, the contractors said we would have loved more testing time but we think we're ready to go ahead. >> i believe that will ultimately be a dispute between cms and hhs and the contractors and if there is anything question do regarding that because, obviously that, didn't work. and i had thought given this as the signature issue with the president that the website would be ready. number two, in my judgment the president's statementes were
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overstatemen overstatements. there's a report in the new jersey newspaper this is morning that 800,000 people in new jersey who purchased their policies in individual or small employer markets will be affected by this. mr. walden in a previous question mentioned the fact that in an individual market you would be able to keep your policy grandfathered. yet regulations issued by hhs say that grandfathered status would not be a continued for so much as a $5 change in a co-pay. is that accurate? do you believe that that is a significant change? >> sir, we gave, i think in, the grandfather regulations a guide for how pricing could change, medical inflation and i think it was in most cases plus 15%. there were some individual consumer outfacing issues that
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were more rigid than that. but i would say that in terms of having companies being able to collect a profit margin, that was certainly built into the grandfather status. >> i think that's too little a change. >> the gentleman's time has expired. >> thank you, mr. chairman. welcome, honorable secretary. thank you for fielding our questions and for responding when you were extended the kurt stoi off -- courtesy to offer a response. as a strong supporter of the aca, i'm frustrated and it's fair to say the american people are frustrated as well. i heard you hear many times this morning say you're frustrated. i think by and large people want this law to work. when i talked to folks back home in the capital region of new york that i represent, even people who oppose the law initially aren't rooting for the failure of the affordable care act. instead, they want congress to come together to fix these
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problems so that we can move on to real issues that matter like creating jobs and growing the economy. my home state of new york which also experienced website problems at the outset has now completed enrollment determination on over 150,000 new yorkers. with more than 31,000 having already signed up for quality low cost health insurance. given that many states have had success in overcoming the initial website issues, has hhs looked at what the state web sites are doing as it searches for solutions to fix health care? >> absolutely. and we shared a lot of the information going in. i think that the hub feature that we have in our website that all states are using including the state of new york is fully functional. and that's good news for new york and california and other who's are running their own state web sites. but we are learning from them. we've shared information with them and we are eager for all the help and assistance moving
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forward. >> thank you. similarly, some states made the choice of rejecting medicaid expansion that would help some of the poorest citizens get access to the health care situation. this is despite the fact that medicaid expansion is entirely financed by federal dollars. can you comment on hhs' plan in the future to encourage more states to run their own marketplaces and expand medicaid so the law can function as designed? >> absolutely. most recently last week the state of ohio did move into the medicaid market. and we now have 30 governors, i think 27 states have fully completed the process and another three are in the process. republicans and democrats who some of whom sued us about the constitutionality of the act who are now deciding that for the citizens of their state they want to be part of the expanded medicaid. we'll continue to have those conversations. it's not just about the marketplace. it's also about medicaid. >> thank you.
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>> the gentleman's time expired. dr. cassidy? >> you said that only if an individual policy is only canceled if it changes significantly. but to be clear, after may 2010 if co-insurance went up by any amount, even by a dollar according to your regulations, that would not qualify as a grandfathered clause. just to add that out there for the record. i gather even by a dollar. that said, i get a letter from someone in my district, adrian. she says that -- she lost her coverage. she lost her coverage because spousal coverage is gone. she's gone on the exchange. she doesn't qualify for subsidy. but that her premium and out of pocket costs under any plan is $10,000 a year. she feels she -- she writes this. she feels betrayed by her government. she has to sit there asking herself is this fair? if you were she, do you think that this would be fair?
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>> dr. cassidy, i want to start by the amount that you gave is not accurate. i was told $5, not $1. >> that's for the co-pay, not the co-insurance. for the co-insurance, it's any amount. i have limited time. do you think -- if you were she, if you were adrian, do you think is fair? losing her spousal coverage and now $10,000, no subsidies? >> sir, i don't have any idea what she's looking at. i can tell you that, again, based on what we've seen in the market and what we've seen in the plans, people will be getting full insurance for the first time at a better rate. >> again this is what she reports. do you think it's fair -- if what she reports is true, do you think it's fair? >> i can't answer fair or not fair. i don't know what she was paying or what she is paying now. did she have full insurance? >> richard writes that his daughter received a note that his premium is going up because she's being lumped with older, costlier patients. now it's possible that the only people that sign up will be those would are more costly.
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does hhs have plans on what to do if only those who are more costly sign up and premiums rise for snerve. >> everybody? >> sir, that's what we're trying to do to make sure -- >> but if only the costly sign up, do you have plans? >> that's the importance of the individual mandate you just outlined. getting rid of pre-existing conditions, making sure that people -- >> do you have backup plans? >> we will encourage others to sign up. it's why there is a penalty in place. >> is there to assume there are no backup plans? >> the gentleman's time has expired. >> thank you, mr. chairman. madam secretary, nice to see you. come to this hearing with a little different perspective. kentucky's doing a great job with our exchange. as of this morning we had 350,000 people who explored the website. 59,000 started applications, 31,000 are now fully enrolled and new coverage and 5,000 just in the last week. and i think very importantly,
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more than 400 businesses have begun applying for their employees as well. so, yeah, the idea this is going to be bad for businesses is not borne out in kentucky. would it be safe to say that if 36 states have done what kentucky and new york and california have done instead of 14 that the rollout would have been much smoother and the website would have been much easier to construct? >> i don't think there's any question that, you know, in january of 2013 we knew how many states were not running their own website and i think mid-february we learned about partnerships. so it was not until that point that we learned that 36 states would actually be coming throughout website. having said that, we should have anticipated. we should have planned better. we should have tested betterment we clearly are running very different vehicle for enrollment than we thought we were going to run in march of 2010. >> right. >> on the subject of cancellation of policies, isn't
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it true that first of all the federal government can't require insurance companies to sell insurance? >> that they can't -- >> the federal government can't require insurance companies to sell insurance? >> yes, sir. >> in fact, insurance companies all over the country are making very difficult decisions now about where they want to participate and where they don't. in some markets they're actually trying to get out of the market cancelling people because they want to play in other markets and so forth. they're all making the decisions now. >> we know we have more insurers. 25% more insurers in the individual market than we did prior to the law being passed. >> a lot of dynamics going on here that are not necessarily an indication that the president misled anybody. they're business decisions being made? >> in cancellation policies that one-year contract notice is a routine in the individual market. it has been in place for years. and for a lot of people, they are being canceled because
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they're being notified you can no longer be medically underwritten. we won't ever have the kind of limitation on what your policy can pay out or charge you out of pocket rates. those policies will cease to be offered in the marketplace. >> the gentleman's time has expired. mr. guthrie? >> thank you, madam, secretary, for being here. last week we had a guess and the president talked about the alternatives to the website. his phone calling or using paper applications. what he said, i think you said it with the phone, they take the paper applications but they enter them in the same web portal. i know you get the issue of being logged on and off:but there rish u there a -- but there are still issues. it is six to eight weeks to be processed.
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so if this will be ready in november 30th, you're getting close to january 1st if it's eight weeks and somebody does lose their insurance so they're signing up for this. even though you have a march 31st open enrollment, what happens to these? is there a contingency plan for the people to continue their insurance? >> sir, i think that we have improvements every day on the speed of the site. circo was giving you early snapshots of difficulty of accessing the site. i think that's greatly improved. >> they said just processing the paper, actually. >> i understand. but it is the site for -- they put the application into the site and get a determination. that's part of what the process is. so the site is part of the portal all the way through. there is an integrated insurance vehicle. and so that will improve. and we, again, with four months of continuous service which is far longer than most people had, some of these cancellation
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numbers, again this was pointed out from florida blue cross, it's true of everyone else, these are not january 1st numbers. they are year long numbers. so over the course of 2014 when an individual's policy is due to expire, that individual -- >> but it could expire january 1st and not be able to get coverage if the website -- and the vendor said they needed months to test. they would have liked to have months to test. that's what they said f we're going to get to -- even if it works november 30th. >> we're testing as we go. there is beta testing going on now. that's how we are fixing and identify to identify things. people are getting through every day and we know more -- >> with the paper process, if it does take four weeks, november 30th and people's cancel january 1st, there needs to be contingency for that person. >> typical insurance is 2 to 4 weeks of signup. they will have two full months of signup. >> thank you, madam secretary,
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for bringing to millions of americans access to affordable comprehensive health care coverage that's going to be there when they need it. i want to thank you especially as a woman. women can no longer -- being a woman can no longer be considered a preexisting condition. women can no longer be charged more than a man for same coverage and have access to comprehensive benefits like prescription drugs and preventive screenings and free contraceptive coverage and maternity care which is often left out of coverage. the days of complicated pregnancy or domestic violence being a preexisting conditions, those days are over. i want to say to my colleagues after a three and a half year campaign to repeal, to discredit, to even shutdown the government over obama care, i want to say, get over it. we all agree, that there are
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problems but these are problems that i see being fixed. i want to say that what we did under medicare part d can be an example of how we can work together. and in fact, chairman upton and i both sent a letter asking for more money for community based groups to help implement the program and make it work. we can work together. so if you could just briefly say how are the navigators -- how important are they in making this system work for the american people? >> well, what we know, congresswoman, a lot of people are not web savvy and are not frustrated by the website because they don't have a computer. they don't want to use a computer, don't trust a computer. they need a live human being to ask questions and get questions answered and talk about the plan and talk about insurance. so the navigators play a hugely
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important role. we have 2500 trained navigators on the ground right now. we have thousands more community assisters are trained and ready to go. 45,000 agents and brokers have gone through specific affordable care act training. but those individuals working with their clients, customers and in the case of gafnavigator the public at large, they are not paid by a company and want to help people get coverage, they are hugely important. >> gentlelady's time -- mr. olson. >> i thank the chair and welcome madam secretary. >> thank you. >> i would like to open with a quote from american icon, i'll hold up a poster. it says, if the user is having a problem, it's our problem. i'm glad to hear you raised this philosophy during your testimony today, ma'am. obama care was signed into law
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1,256 days ago. and since then, there's been user problem after user problem after user problem. regarding, your dputty administrator for consumer information, gary cohen, testified one month ago, where we are sitting, that cms has worked hard to test the infrastructure that will allow americans to enroll in coverage confidently and simply and securely, end quote. and yet according to forbes, and the wall street journal, you told them that you need five years of construction and one year of testing. the program crashed and burned at least three times and the user is still having problems. it's been down the whole time you've been testifying. the system is down at this
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moment. my question, ma'am is very simple. when did you know these changes were going down? a month, a day, a quarter? and did you tell the president what you knew? >> sir, i was informed that we were ready to launch on october 1st and the contractors who we had as our private partners told us and told this committee that they had never suggested the delay and that is accurate. our cms team felt we were ready to go. i told the president that we were ready to go. clearly i was wrong. we were wrong. i knew that in any big new complicated system, there would be problems, no one ever imagined the volume of issues and problems that we've had. and we must fix it. >> yes, ma'am. but credible journalists said you knew you needed six years --
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>> that quote has been repeated. i can guarantee you i would have never stated that because the law was passed in march of 2010. i chose the open enrollment date. i don't know where the quote comes from but that is not from me. >> gentleman's time is expired. >> thanks for attending, i suspect deep down most support the concept of reforming insurance market so people have better access to coverage. we have disagreements by the means to get those in. it seems that every day we're hearing something new going wrong. i'm concerned the short term enrollment problems could become long-term insurance market problems. my constituents already losing confidence the federal government is ready to pull this off and in order to restore the trust, to delay the individual mandate penalties until we're sure the system is going to work. not fair to penalize consumers when it is not their fault and make sure additional fits and starts won't cause larger problems. right now less concern about
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who's to blame and how to fix it and to ensure it doesn't happen again. all of our constituents want and need health insurance. it would be a huge mistake if we're blinded by our love or hatred that we miss opportunities to address its flaws. to the subject of technical problems becoming market problems. can problems of folks getting into the system snowball into risk pool problems where those who choose not to enroll affect the costs of those who do enroll? >> certainly a risk pool needs a balanced market. you need people who are older and sicker to be balanced with people who are younger and healthier, that's how a pool works. >> at what point will we see a problem having the risk pool if the tech problems cause -- effect entering? what are we going to look for and use to decide something needs to be done? >> again, sir, we will be monitoring during the six months of open enrollment as will our insurance partners who is coming
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into the pool, that's why we want to give this committee and others reliable and informed data about not only who it is but what the demographics are and where they live. >> if things aren't better by the end of the next month, at what point do we think about further delays in posing penalties? >> i think that having a defined open enrollment period is one of the ways that you then make an assessment if you have a pool that works or not. you cannot have an unlimited open enrollment period with any insurance company because that really doesn't work. >> thank you. >> mr. mckinley. >> thank you, mr. chairman. >> last week -- last week the cji representative at campbell said she met her contract obligations and met specifications and said the only problem she had was with pace. but the pace wasn't part of the specification. do you -- and we asked her, you
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would testify to, did -- she said you would testify that she did complete her contract in accordance with the specifications. would you? >> sir, i don't think it's how the product is working that it's supposed to work that anybody finished their job. >> they shortened our time with it. >> so, if she hasn't met their specifications and yet we're still using her, is the american taxpayer still paying money to fix the problems that she didn't do -- her company didn't do in the first -- >> none of our contractors have been paid of the amount -- >> will she be paid for this work into the future? >> we will make that determination as the work goes forwards. as we learned what needs to be fixed -- we'll know about -- >> i'm sorry the time frame, cut it down. >> who owns the software, now that this has been developed with taxpayer money to develop the software to do this -- >> it is owned by the centers
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for medicaid and medicare services. >> will they be able to use it by license with other clients? >> not to my knowledge. i think it is specifically designed for the marketplace with these products in minds. >> the last question to try -- >> the clients are the american public. >> under iv and v, she testified that she thought that was something we should have done. under hhs, you recommend or the hhs recommends that for software development, they should have a independent verification and validation program. can you share with us in the time that's gone why we didn't use iv and v -- >> i don't think that's accurate. at every point there is independent testing. >> independent. >> yes and outside -- >> you recommended verification and validation not someone within your staff? >> pardon me? there is a level of
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self-attested testing and cms testing and independent test on each piece of the contracting. >> not cns. >> that's what -- >> gentleman's time -- >> it needs to be done independently, people who do not have -- >> is expired. >> i'll get you the information. there are three levels of testing, one is independent for every piece of this contracting, yes. >> mrs. caster. >> good morning, when open enrollment began a few weeks ago the people back home in florida helping neighbors sort through the new options for coverage, the navigators, were taken aback by how grateful people are to have new pathway to the doctor's office and the care they need. affordable options. the -- there are no longer being discriminated against because they had cancer. and diabetes or asthma.
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they are very grateful. they said, they said to me directly, it's like they found water in the desert. right now they are surprisingly -- they said it's taking time because people want to sort through all of these options. before they finally sign up at the end of the 26-week enrollment period. we must fix the marketplace to meet their expectations and we have high expectations for you and the administration. i think it's important to point out it's more than just a website. it -- despite the obstruction by republicans in my home state of florida, nationally, even going so far as to shut down the government, millions of americans are already benefitting and there are benefits that are not tied to some madam secretary, let's clarify what's working. is it correct to say many of the improvements that the aca makes
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to employer coverage and medicare were the vast majority of americans receive their coverage are not dependent on >> that's correct. >> so the delays and problems with do not affect the millions of individuals thanks to the aca who no longer have to worry about lifetime monetary caps on their coverage that previously sent them to bankruptcy? >> that's absolutely true. i think the quote that the president was quoted recently saying if you have health care, you can -- you don't have to sign up for the new marketplace was referring to the large portion, the 95% of insured americans who plans are solid and stay in place and move forward. >> i understand the frustration with the website. i don't know why people are not similarly outraged by the lack of medicaid coverage in many of our states. do you find that hip critical? >> i think it's very troubling that millions of low income working americans will still have no affordable option if
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states don't take advantage of the expansion program leaving states bearing the cost of uncompensated care and families and workers not able to go to work and people still accessing care through emergency room doors. the most expensive, least effective kind of care they did g . >> mr. gardner? >> thank you for being here. here's my letter. this is the letter my family got canceling our insurance. we chose to have our own private policy back in colorado so we could be in the same boat as everyone of my constituents. and yet my insurance policy has been canceled. the white house website says if you like your health plan you have, you can keep it. did i hear it wrong? >> again, sir, i don't know how long you've had your policy -- >> why aren't you losing your insurance? >> pardon me. >> why aren't you losing your health insurance? >> because i'm part of the
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federal employees -- >> you're in charge of this law, correct, why aren't you in the exchange? >> because i'm part of the federal employee health benefit plan. >> why won't you go into the exchange? you're a part of this law, literally in charge of this law. should you be any different than the americans out there losing their health insurance? >> i'm part of the 95% with affordable eligible health care coverage. >> most americans aren't available to them. why will you not agree -- >> i'm not eligible for the exchange because i have coverage in -- >> you can decide to drop your coverage of your employer. you have the choice to decide not to choose -- >> that the not true, sir. >> members of congress are now part of the exchange thanks to an amendment that was added by congress but i'm not eligible. >> with all due respect. >> if i have affordable coverage in my workplace, i'm not eligible to go into the marketplace, that's part of the law. >> madam secretary, i would encourage you to be just like
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the american people and enter the exchange and agree to find a way -- >> it's illegal. i would like to show you an advertisement going on in colorado right now. this is an advertisement that a board member of the colorado exchange put forward, do you agree with this kind of advertising for obama care? >> i can't see it. >> it's a college student doing a keg stand. >> if the colorado exchange did that -- >> do you approve of this kind of advertising? >> i don't see it, don't know what it is and i did not approve it. this is a state based -- >> that's a pretty big picture of a keg and you can't see it? >> do i approve of it? >> you have athe built to opt out and you could take the insurance. >> if i have available employer based coverage -- >> i would like to submit a waiver from my district from obama care and hope you consider waiving it for the fourth congressional district. >> gentleman's time is expired. >> does your policy covered?
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>> mr. mathison. >> thank you, mr. chairman, madam secretary, thanks for your time. i want to ask on the issue of the fixes to, we've had a lot of conversation about that today and talked about confidence levels for being ready by a certain time. i think one question that a lot of us have is, can you define what the magnitude of the problem is? is there a scale or metric by which we can understand how bad this is today and how we're going to get to where we go to have it fixed? >> well, again, sir, i've been informed that the problems are in -- the reports i've seen are really in two areas, they are in the performance area, which is speed and reliability. it's too slow and doesn't have reliable transfers and in functionality, there are parts of the system that don't make accurate transfers. so we have done an extensive
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assessment. they are prioritized. one of the priorities is the enrollment features which pass individual information to the companies where they want to enroll. that is not reliable at this point. the companies are not getting accurate data. so an example of the kind of thing we know we need to fix. >> is there a way to -- if you set up metrics figure out if we're making progress in terms of fixing those issues with speed and performance and functionality. >> with the team and jeff zienst at the head of it, there are comprehensive set of issues that will be measured and accelerated. >> do you have target dates along the way if you want to meet the november 30th time, assume it's functional of what you want, do you have target or metrics along the way to make sure you're on the path? >> my understanding is there are sort of groups of targets that
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fixes that can be loaded together. it isn't one at a time. they don't take days but they are try being to determine with a specific path, one of the charges that qssi has, really looking at the umbrella of what needs to be fixed, prioritizing them, figuring out what destabilizes if something else is fixed and how they can be grouped together. and that report will be in later next week. >> gentleman's time is expired. >> thank you. i would like to talk about kansas a little bit today. much like with some of my colleagues have made references to the wizard of oz, i don't think anybody not from kansas should do. they worked awfully hard to go down the yellow brick road. when they pulled back the curtain, they found there was nothing they didn't already have. and as we pull back the curtain, people are finding it's not exactly what they have worked so hard to find their way too as
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well. two stories, there's this commitment, if you like your plan you can keep it. i have a letter from mr. breeto in kansas, saw him in benton, he got the letter that says because your current plan does not offer the benefits standard qualified you'll be discontinued -- says good news, then there's a group of folks, pizza hut from kansas, franchisees, lots of folks have taken employees and families working there, gone from having full-time jobs to part-time jobs. they aren't able to keep the health care plan they had either and the one they wanted. what do you tell -- why were the plans these folks had good enough when you were the insurance commissioner in kansas and when you were kansas' governor but the plans today aren't good enough for those hard working kansas families? >> sir, i would tell you in the roles i had the honor of serving
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in in kansas, i worked every day to try to eliminate the discriminatory features of the insurance industry that finally with the affordable care act are gone. my successor and elected insurance republican commissioner sandy kraeger and i worked on a whole series of plans to expand coverage. i did work on these issues and we were not necessary -- >> you say these were lousy plans and miss tavenner said no true insurance. do you think the plans weren't true insurance? >> in the individual market, the insurance commissioner in kansas and virtually every place in the country -- >> it's a yes -- >> it's a yes or no question. were they true insurance plans? >> a lot of them are not true insurance plans, no. >> i yield back. >> gentleman from vermont. >> i'm going to summarize what i've been hearing. number one, the website must be fixed. you've been very forthright and you're going to fix it.
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number two, we've had a real battle about health care, had a battle in this congress. it was passed and the president signed it and the supreme court affirmed it, a brutal battle. there was an election people where the american people affirmed it and then the shut down in the threat of deabt default. all of us represent people who are going to win or lose depending on how effectively this is rolled out. there's significant question about existing insurance policies what the president said and so on. let's acknowledge something. a lot of insurance companies were ripping off innocent american people by promising them insurance until they got sick and then it got canceled because they had a preexisting condition that wasn't disclosed. that's got to end. the challenge for us going forward is to make health care
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affordable. madam secretary, my question is, is there any indication that there's been a slowing of premium increases as a result of the affordable care act because, unless we can keep those premium increases down, they can't rise faster than the rate of inflation, all of us are going to lose. >> i would say the trends in the private market over the last three and a half years are that cost increases have slowed down. are rising at a lower rate than the decades before. in fact, in this individual market, the old individual market, the typical increase was 16% year in and year out rate increase. often that came with additional medical underwriting. it gives a sense of how the costs were. we know that medicare costs are down and medicaid costs had a decrease per capita last year, not an increase per capita and underlying health care costs are
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down. these rates in the new marketplace have come in about 16% lower on average than was projected. not by us by by the congressional budget office. and we know that in many of these markets, they are much more competitive. i believe in market competitiveness. that drives down rates. the states where the most companies are participating, have the lowest rates. and new companies have come in, significantly below the old monopoly companies that dominated this individual marketplace. we're on a pathway. are we there? no. affordable coverage at the end of the day for everybody is the goal. >> i yield back. thank you, madam secretary. >> i'm trying to make sure you're out of here by 12:30 before we start the second round of questions. >> mr. kissinger. >> that was a joke, right? >> i see sheer panic. >> thank you for being here. you stated earlier to mr. har better, you give the president
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regular updates and the president said he knew nothing about the status and functionality of the marketplace. how often and what were the subject of those updates? >> i think there were a series of regular meetings with the president with some of our federal partners with offices of the white house from the omb to others on a monthly basis, giving reports on policy and where we were going, none of those i would say involve detailed operational discussions. that wasn't the level. it was are we coming together? do we have companies and plans. >> i understand that. obviously when it comes to the president of the united states, certain level of details you have to see kind of 10,000, 20,000 foot overview. in terms of functionality, he was legitimately caught off guard on -- >> i assured him and -- that we were ready to go.
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everyone knew with the big plan that there were likely to be problems. no one anticipated this level of problems. >> just a quick question. where is hhs getting the money to pay for fixes? is it coming from other hhs accounts? have you used your transfer authority to move money from nonaca programs to pay for the cost of implementing the president's health care program? if so, from which have you drawn money to help with the fix that's not aca related? >> as you know, congressman, it's been two years since we've had a budget at hhs. we also have not had at the president's requested implementation budget, authorized by the congress, each of those years we have used not only resources internally but i do have legal transfer authority that i've used and a nonrecurring expense fund. we'll get you the details of
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that. >> the answer is yes, there are non-aca money being used for the implementation -- >> there is money that is specifically designed for either outreach and education, so health centers hired education and outreach people as part of their outreach for health personnel. i would say it's definitely related cause to get expanded health care. >> thank you, mr. chairman. >> thank you, mr. chairman, thank you madam secretary for being here. my understanding is that a lot of the companies insurers that have been offering plans in the individual market, the ones sending out these notices, are actually repositioning themselves in the health insurance exchange to offer alternative plans. is that -- >> yes. >> and in addition to those insurers who have been in the individual market, you have a lot of other companies and insurers providing plans in
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health insurance market? >> that is true. >> so the way i look at this. i went to buy oriole tickets when the season was underway. they closed the window. i didn't have to go home because they opened another window a few feet away. so essentially what's happening is people are coming up on the renewal period and getting up to the window, the individual market and being told that window is closed but if you go right down the line here there's another window that's open. by the way, when you get there, you'll get better coverage, potentially at reduced premiums. if you go down to window 3, these subsidies that may also be available to you. this notion that people are being turned away from an affordable product, that provides good quality care, is prepostero preposterous, they are being steered to a place where they
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can get good quality coverage, in many instances much better than the coverage that they had before, at an affordable rate that is supported by the subsidies that can be available to many, many people. this is what is so promising about the affordable care act. so i think it's important for people to understand that that window is not being shut. they are being steered someplace elsewhere they can get a good opportunity. >> i think the first option for those companies is to say we'd like to keep you here and here are the plans we're offering. but to be fair, customers will now have an opportunity to look across a landscape, which they couldn't before. they will have entry into those other windows, which many of them didn't have before with a preexisting condition. as you say, 50% of the market will have financial help in purchasing health insurance which none of them had before. >> gentleman's time expired. mr. griffith.
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>> earlier in your testimony here today you said a couple of times, plans we enjoy but then as you noticed with mr. gardner's eloquent testimony, we're not going to be in the same plan you're in. i was one of those that thought it was a good idea as part of a proposal floating around the halls here in congress, that the president and cabinet secretaries ought to also be in the marketplace and not have a special federal plan that is you will have after january 1 and we will not. the president while that was being discussed issued a veto threat. did you discuss the veto threat with the president before he made it and have you discussed it with him since then? >> no. >> and then i will ask you relating back to the contractors involved in this. cgi told us that the spanish website was ready to go. that they thought everything was ready just as they did with the regular site. that didn't prove out. but that they were told not to implement it. likewise the shop and browse section was ready to go.
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do you think they were misleading this committee when they made comments? >> i think what they believed is that that product independent of the entire operational site was ready and tested. what a determination was made -- i was involved with the spanish website and medicaid transfers to say let's minimize the risk for the whole site -- >> that raises the next question up, because one of the other contractors qssi, i believe, indicated that part of the problem because once you took away the opportunity to browse, every had to set up an account and cms stopped one of the browsing options as well and that contributed to the log jam and contributed to the problems. isn't it -- is he correct on that, that not allowing people to look without having to sign up, wouldn't that have made it easier for the american people? >> in hindsight, that probably
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would have been advantageous, i can tell you the decision made going forward was to minimize risk, that didn't work so well. adding additional features that didn't involve people wanting to get to what they would independently pay and what they would qualify for and what the plans were seemed to be things that could be added down the road. it was wrong. >> gentleman's time is expired. >> i appreciate it very much, mr. chairman and thank you, madam secretary, for testifying today. over the week in "the new york times" wrote the following, project managers at the department of health and human services assure the white house that any remaining problems could be worked out once the website went live. other senior officials predict a serious trouble and advise delaying the rollout. can you confirm this is true? did any senior official predict serious problems and did any senior department officials advise delaying the rollout of the exchanges or parts of the
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exchanges on october 1st? >> i can tell you that no senior official reporting to me ever advised me that we should delay. you heard from the contractors on the 24th that none of them advised a delay. we have testing that did not advise a delay. so not to my knowledge. >> did they indicate to you there were serious problems? >> they indicated to me we would always have risk because this system is brand-new and no one has operated the system like this before to any degree. so we always knew there would be the possibility that some things would go wrong. no one indicated this could possibly go this wrong. >> can you name some of the officials that gave you the advice, that there were serious problems? >> again, we had series of meetings with teams from cms. i was always advised that there is always a risk with a new product and new site. but never suggested that we delay the launch of october 1st,
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nor did our contracting partners ever suggest that to us. >> thank you, madam secretary. >> thank you, mr. chairman, yield back. >> mr. johnson. >> madam secretary, thank you for being with us here today. cms was the integrating prior to the rollout, correct? >> that's correct. >> you testified you hired an outside company to serve -- >> one of the contractors -- >> who is is that? >> qssi, who built the hub. >> the same company that told our committee last week they were not only the developer of the hub and pipe line but also an independent tester of the system. >> you've acknowledged in your testimony today that inadequate testing played a significant role in this failed launch, aren't you concerned qssi has lost its ability to be an objective independent arbitrator in addressing the problems that plague the system now? they are part of the tester and part of the developer and part of the problem. >> i haven't lost confidence in
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them. the testing they did is valid ating the pieces of the equipment, what we said, since the launch is we did not do adequate end to end testing, that was not the qssi responsibility. >> in this new roll as integrater, are are you going to be paying them more than they were paid under the original contract? i would expect -- >> that discussion is under way in terms of what the role will entail and outlines are, yes,sir. >> hard working american taxpayers have already paid for this implementation once. do you think it's fair to ask taxpayers to pay more so qssi can attempt to do something that administrator tavenner and her team were unable to do right the first time. >> the american taxpayers expect us to get the site up and running. >> any expected it the first time. >> i understand and so did i.
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we have not expended the funds that have been encumbered forred contracts. we'll monitor every dime we spend and reaudit things that are going forward. >> with that, mr. chairman, i yield back. >> gentleman yields back. mr. long. >> thank you, mr. chairman and mr. secretary for being here today. given your testimony, earlier today you said that i'm responsible for the implementation of the affordable care act. i've heard you referred to and maybe yourself as the point person for the rollout, the architect of implementing affordable care act. so you are kind of the president's point person, are you not, for this rollout? >> yes, sir. >> i earlier you were asked -- there's a lot of things striking about the rollout of this and about affordable care act all together, but the thing most striking to me, is when we had the point person for the rollout here, and you're not going into
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the exchange. i've heard you say, that -- and you got advice from the foekds behind you, but i'm asking you today, can you tell the american public if your advisers behind you, if they happen to have given you wrong information, if it is possible for you to go into the exchange, like all of these millions of americans going into the exchanges, will you admit to forego your insurance plan you're on now and join us in the pool. water is fine. all of the congressman and staff have to go into the exchanges. we have to go into the d.c. exchanges. i will say i tried to get on the website. was successful during the hearing earlier and got to the d.c. exchange where i have to buy from. i got part way through and when i got to part to enter my social security, i could not bring myself people to do that when i heard from folks about the security. if your advisers are wrong and it is possible for you -- i'm not saying it is, if it's possible for you to forgo your
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government plan, will you tell the american public, i'll go into the exchanges next year like everyone else? >> the way the law is written -- >> it's a yes or no. >> let's say you're wrong on that. if you're wrong -- >> i don't want to give misinformation to the american public -- >> what? >> i don't want to give misinformation who have affordable coverage -- >> women you go into the exchanges? >> if you can, will you? that's a yes or no. >> i will take a look at it. i don't have any -- >> that's not a yes or no. >> gentleman's time is expired. >> you're the architect of the whole program and you won't go into it -- >> i did say not say it. it's illegal. >> if it's not illegal -- >> will you go in? >> affordable coverage -- >> the water is fine. >> gentleman's time is expired. >> i have a unanimous consent request, i'd like madam secretary, i'd like you to
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answer for the record if you were able to do what the gentleman just suggested or follow the recommendation of cory gardner, our colleague from colorado and went into the -- to buy an individual policy, would you be able to find one that would protect you from cheap shots or do you think it has to be mandated for coverage? i leave it -- the record open for your response. >> we'll wait for that response to come back. >> gladly go in the exchange if i didn't have affordable coverage in my workplace. i would gladly join it. and the d.c. market is an independent state based market even though d.c. is not a state. we do not run the d.c. market in the federal marketplace. >> gentlelady from north carolina, miss elmerz. >> i have a couple of questions, thank you for being with us today, madam secretary. i would like to go to the issue raised by my colleagues here
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about accurate information. number one, i've heard the issue of medicaid part d brought up, many, many times, although my colleagues all voted no against it initially, now they are stoeing the virtues of medicare part d. is it a mandate or is it voluntary? >> it is a voluntary program. that's the first piece of accurate information i would like to get. we're asking or we're actually forcing millions of americans to go to find a health care premium in some way, whether it's to go to the exchange or whether they are to be insured, many of my constituents are being -- are reaching out to me those with individual policies and they are saying to me that my rates are going up 400%, my rates are going up 127%, these are my constituents. now, we're talking about open enrollment, but it's forcing the
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issue, is it not, that if an american does not have health care coverage, they are essentially breaking the law? is that not correct? >> if someone can afford coverage and has that option and chooses not to buy coverage, they will pay a fee on their -- >> and it is a law so there are they are -- >> you also brought up the issue quh you were in kansas that you fought against discriminatory issues. as far as the essential health benefits, correct me if i'm wrong, do men not have to buy maternim maternity coverage? >> policies will cover maternity coverage for young and healthy. >> including men. >> under 30-year-olds will have a choice also of a catastrophic plan which has no maternity coverage? >> catastrophic. but the men are required to purchase -- >> an insurance policy has a series of benefits, whether you


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